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Principles2 > Trauma > Flashcards

Trauma Flashcards

1
Q

for penetrating trauma, energy is transferred to the body when? (ATOI)

A

at time of impact

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2
Q

for perforating trauma, energy is deposited where? (ITT)

A

in the tissue

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3
Q

what cervical spine number is the most commonly injured?

A

C7

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4
Q

what are the 6 P’s of SCI?

A

pain, paralysis, paresthesia, position, ptosis, priapism

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5
Q

high SCI can result in knocking out the sympathetic mediated fibers resulting in no opposition of vagal innervation when the injury is greater than what thoracic number?

A

T6

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6
Q

Succs is okay in the first how many hours after SCI?

A

48 hours

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7
Q

what are the 5 S/S of spinal shock below the level of the lesion? (B, A, GA, H, H)

A

bradycardia, atony, GI atony, hypotension, hypothermia

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8
Q

what is the “drug of choice” for spinal shock?

A

dopamine

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9
Q

short term high dose therapy of what improves neurological outcomes in SCI?

A

steroids

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10
Q

what is the methylprednisolone dose for first hour after SCI? (mg/kg/hr)

A

30 mg/kg/hr

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11
Q

what is the methylprednisolone dose for last 23 hours after SCI? (mg/kg/hr)

A

5.4 mg/kg/hr

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12
Q

where is the trigger located that causes autonomic hyper-reflexia?

A

below the level of injury

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13
Q

what are the 3 treatment options for autonomic hyper-reflexia? (RS, DA, AV)

A

remove stimulus, deepen anesthetic, administer vasodilator (nicardipine, nitroglycerine, nitroprusside)

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14
Q

autonomic hyper-reflexia: vasoconstriction above or below SCI?

A

below

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15
Q

autonomic hyper-reflexia: vasodilation above or below SCI?

A

above

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16
Q

what is the cardinal sign of autonomic hyper-reflexia?

A

paroxysmal HTN with severe bradycardia

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17
Q

autonomic hyper-reflexia happens in pts with a chronic spinal injury above what thoracic level?

A

T5-6

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18
Q

what is the preferred means to maintain a patent airway in a trauma pt? (JTWIS)

A

jaw thrust with inline stabilization

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19
Q

do you avoid N2O in trauma pts?

A

yes

20
Q

what should FiO2 always be at?

A

100%

21
Q

what 2 scans are the “gold standard” for SCI?

A

CT or MRI

22
Q

what are the 2 views for preliminary C-spin fx?

A

lateral and swimmer’s view

23
Q

what is the ketamine trauma dose? (mg/kg)

A

0.5-1 mg/kg

24
Q

what is the etomidate trauma dose? (mg/kg)

A

0.1-0.2 mg/kg

25
Q

what is the thiopental dose? (mg/kg)

A

0.5-2 mg/kg

26
Q

what induction agent causes hypotension?

A

thiopental

27
Q

what induction agent causes enhanced C/V stability and decreases CMRO2, CBF and ICP?

A

etomidate

28
Q

what induction agent increases CMRO2, CBF, and ICP?

A

ketamine

29
Q

what 2 muscle relaxants cause histamine release?

A

atracurium, mivacurium

30
Q

what are 7 signs of a pneumothorax? (H, SQE, IP, IBS, HR, TS, DNV)

A
  1. hypotension
  2. SQ emphysema
  3. increase PIP
  4. ipsilateral breath sounds
  5. hyper-resonance
  6. tracheal shift (late sign)
  7. distended neck veins
31
Q

what is a temporary fix for a pneumothorax?

A

14 gauge IV 3-6 cm long into 2nd ICS midclavicular line

32
Q

what are the 3 signs of Beck’s triad?

A

neck vein distention, hypotension, muffled heart tones (also widened mediastinum)

33
Q

for a flail chest is there inspiratory or expiratory retraction?

A

inspiratory

34
Q

is a hemothorax dull or hyperresonant?

A

dull

35
Q

Blood volume deficit for these:

  1. unilateral hemothorax
  2. hemoperitoneum with abd distention (range)
  3. pelvic fx (range)
  4. femur fx (range)
  5. tibia fx (range)
A
  1. 3000 mL
  2. 2000-2500 mL
  3. 1500-2000 mL
  4. 800-1200 mL
  5. 350-650 mL
36
Q

Hemorrhage classifications (% of TBV and mL)

  1. Class 1
  2. Class 2 (range for both)
  3. Class 3 (range for both)
  4. Class 4 (range for both)
A
  1. 15%, 750 mL
  2. 20-25%, 1000-1250 mL
  3. 30-35%, 1500-1800 mL
  4. 40-45%, 2000-2500 mL
37
Q

HR and RR > what for these hemorrhage classes:

  1. class 2
  2. class 3
  3. class 4
A
  1. HR > 100, RR > 20
  2. HR > 120, RR > 30
  3. HR > 140, RR > 35
38
Q

SBP for these hemorrhage classe:

  1. class 2 (> what?)
  2. class 3 (< what?)
  3. class 4 (< what?)
A
  1. 100
  2. 90
  3. 60
39
Q

Whose law says flow is directly proportional to the 4th power of the radius and inversely related to length?

A

Poiseuelle’s law

40
Q

what is the replacement ratio of crystalloid to blood loss?

A

3:1

41
Q

what is the IV solution for head trauma?

A

NS

42
Q

what is the IV solution for trauma resuscitation?

A

LR

43
Q

what is the replacement ratio of colloid to blood loss?

A

1:1

44
Q

what are the 4 S/S of TRALI? (RD, H, H, LGF)

A

resp distress, hypoxemia, hypotension, low grade fever

45
Q

the ratio of 1:1:1 for blood product transfusion is for what products?

A

PRBC:plts:FFP

46
Q

what 2 ion concentrations increase after a massive blood transfusion?

A

K+ and H+

Principles2 (21 decks)

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