Trauma

Question 1

When should TxA be given?

What dosing?

Answer 1

Significant hemorrhage or shock

1g bolus in hour 1 followed by 1g infusion over 8 hours

Question 2

Transfusion should be done at what ration?

Answer 2

1:1:2

Plasma to Plts to PRBCs

Question 3

When to do permissive HoTN?

What goal MAP?

When is it contraindicated?

Answer 3

Contained hemorrhage, not actively hemorrhaging

> 50

Associated TBI

Question 4

What CPP level is auto regulation lost?

What is the recommended target?

Answer 4

40

60-70

Question 5

ICP occurs at what pressure?

ICP > what pressure requires treatment?

Answer 5

15

> 22

Question 6

Why isn’t hyperventilation recommended anymore?

Answer 6

Dec CO2 leads to CBF (Cerebral blood flow) which leads to cerebral ischemia

Question 7

What Abx to give for penetrating brain injury?

Answer 7

Vancomycin 1g bid
Gentamycin 80mg tie
Metronidazole 500mg qid

Question 8

What size suture to close scalp lacs?

Answer 8

3-0 nylon or polypropylene

Question 9

What are surgical indications for subdural hematoma evacuation?

Answer 9

Thickness > 10mm
Midline shift > 5mm
worsening GCS
Fixed, dilated pupils
Persistent elevation in ICP

Question 10

What is the MC cardiac dysrhythmia after TBI?

Answer 10

SVT

Question 11

How do you define Severe TBI?

Moderate?

Mild?

Answer 11

Postresuscutation GCS of 8 or lower

GCS 9-12

GCS 13-15

Question 12

Injured brain ischemia seen w/partial pressure of CO2 below what level?

Answer 12

20 mmHg

Question 13

Related CBF, MAP, and ICP?

Answer 13

CPP = MAP - ICP

Question 14

When can player return to sports after a sports-related concussion?

Answer 14

Minimum 1 week after they are asymptomatic

Question 15

If the maximal incisor opening is less than ___, a mandibular fracture may be present.

Answer 15

5 cm

Question 16

Describe Ellis class I fracture

Answer 16

Only involves the enamel, not painful, can await outpt referral

Question 17

Describe Ellis class II fracture

Answer 17

Expose yellow dentin, may be painful

Cover with CaOH and aluminum foil

Question 18

Describe Ellis class III fracture

Answer 18

Expose dental pulp (red line) and are V painful

Require dental eval immediately

Question 19

Where does Stenson’s duck enter the mouth?

Answer 19

2nd upper molar

Question 20

B/l fractures through the maxilla above the roots of the teeth is called what?

Answer 20

Le Fort I