Trauma Flashcards
You Send off a TEG and the R time is prolonged, what does that mean?
That means that the time to clot formation is prolonged, meaning that coagulation factors are low and you should give FFP
What does it mean when a TEG has a fishtail?
The client is being broken down too quickly and you need to give something to prevent it’s break down
TXA works well for this
You could also give cryoprecipitate to stabilize clot formation
When should you give TXA in a bleed?
According to the crash 2 trial you should give it when there are signs of DIC or coagulopathy
How does TXA work?
Synthetic amino acid lysine
Blocks plasminogen from being converted into plasmid
Plasmin breaks down clots
What does it mean when you have a TEG that looks like a tad pole?
You are behind on all clot components, You need to give both cryo and FFP
Give platelets as well
Consider giving TXA as well since the clot is breaking down so quickly
How does activated factor seven a.k.a. Novo seven work?
Factor seven is used to initiate the coagulation cascade by binding to tissue factor
What are the complications of novoseven?
Clots were you don’t want them
How many classes of hemorrhage are there? And which class should you consider transfusing
There are four classes, one should transfuse at class III
What is the difference between a class one and a class two hemorrhage?
Class one hemorrhage is less than 15% blood volume loss with no change in vital signs
Class to is 15 to 30% blood volume loss with some sympathetic response, the sympathetic response is enough to compensate
How does one define a class III hemorrhage?
30 to 40% blood volume loss
Compensatory mechanisms Are not sufficient to maintain tissue perfusion leading to metabolic acidosis
Requires transfusion
What is the major driving force in transitioning from the compensatory phase to thecompensatory phase of hemorrhagic shock?
Reduction of response to catecholamines and enhanced release of nitric oxide
