Trauma Flashcards
Bloody vicious cycle
Coagulopathy
Hypothermia
Metabolic acidosis
Bloody vicious cycle complication
Fatal arrhythmia
Indications for damage control surgery
refractory hypothermia <35
profound acidosis <7.2 base deficit <15
refractory coagulopathy
Arterial repair should ALWAYS be done for
Aorta Carotid Innominate Brachial SN Proper hepatic Renal Iliac Femoral Popliteal
Arteries that tolerate ligation
Right and left hepatic artery
Celiac artery
Venous repair should be performed in
Superor vena cava
Inferior vena cava before renal veins
Portal vein (ligated in extreme cases)
Repair should be done but 80% of patients survive even if this is ligated
SMV
Collateral decompression forces this vein to be ligated near IVC
Left renal vein
Normal ICP
Indicative of surgery
Till 10mmHg
> 20mmHg
Indications for operative intervention in space occupying hematomas
Clot volume Amount of midline shift (>5mm) Location of clot GCS ICP
Epidura hematoma complication
Blooc accum forcing tempora lobe medially with resultant compression of cranial nerve III and brainstem
Dilated pupil fixed on ipsilateral side
Goal and rescu mx in patients with head trauma
Avoid SBP <100 (hypotension)
Avoid partial pressure of oxygen <60 or arterial saturation <90 (hypoxia)
Maintain CP
CPP =
Mean arterial pressure - ICP
Target range of >50
Prophyalctic anticonvulsant therapy for IC injuries
Phenytoin Dilantin for 7d
The most common complication after thoracic injury
Empyema
