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Critical Care > Trauma and Burns > Flashcards

Trauma and Burns Flashcards

1
Q

Parkland Burn Formula

A

(4ml x kG) x % of TBSA= total ml over 24 hours
1/2 administered over the first 8 hours
1/2 administered over the next 16 hours

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2
Q

Consensus Formula

A

adminsiter (2-4 ml x kG) x BSA%
1/2 administered over the first 8 hours
1/2 administered over the next 16 hours

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3
Q

Modified Brooke Formula

A

(2ml x kG)x BSA%
1/2 administered over the first 8 hours
1/2 administered over the next 16 hours

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4
Q

Most commonly abused organ system

A

Integumentary System

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5
Q

Most common type of injury associated with acceleration/deceleration injuries

A

Diffuse axonal injury
Occurs when delicate axons are stretched and damaged as a result of rapid movement of the brain

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6
Q

Reccomended site for Chest tube placement

A

5th ICS anterior midaxillary

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7
Q

How much blood should should be removed from the hemothorax before you clamp the chest tube

A

1000ml

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8
Q

According to the rule of 9s
BSA of HEAD of an adult

A

9%

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9
Q

According to the rule of 9s
BSA of ANTERIOR TORSO of an adult

A

18%

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10
Q

According to the rule of 9s
BSA of BACK of an adult

A

18%

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11
Q

According to the rule of 9s
BSA of EACH ARM of an adult

A

9%

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12
Q

According to the rule of 9s
BSA of EACH LEG of an adult

A

18%

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13
Q

According to the rule of 9s
BSA of NECK or Genitals an adult

A

1%

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14
Q

According to the rule of 9s for Pediatrics
BSA of HEAD

A

18%

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15
Q

According to the rule of 9s for Pediatrics
BSA of ANTERIOR TORSO

A

18%

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16
Q

According to the rule of 9s for Pediatrics
BSA of BACK

A

18%

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17
Q

According to the rule of 9s for Pediatrics
BSA of EACH ARM

A

9%

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18
Q

According to the rule of 9s for Pediatrics
BSA of EACH LEG

A

14%

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19
Q

According to the rule of 9s for Pediatrics
BSA of NECK or GENITALS

A

0%

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20
Q

Prolonged crush injury considerations

A

Rhabdomyolysis
HyperKalemia
Compartment syndrome
Acute Renal Injury

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21
Q

Predictable Injuries associated with Head on collision

A

Rib fractures, pnumothorax, hemothorax, concussion, skull fracture, patella and femur fractures, hip injury, acetabular fracture, reptured spleen, liver injury, ruptured aorta

22
Q

Predictable Injuries associated with side impact

A

clavicle, rib femur, tib/fib, fracutre and spleen injury

23
Q

Predictable Injuries associated with roll over

A

multisystem injury

24
Q

Predictable Injuries associated with fall

A

calcaneus fracutre, compression fracutre to T12-L1, wrist fractures

25
Q

Predictable Injuries associated with Rear end collision

A

T12-L1 injuries, femur, tib/fib injuries, ankle fractures and cervical strial, c2 fractures

26
Q

Clotting cascade can be triggered though an extrinsic pathway triggering mechanism is the release of what

A

Thromboplastin

27
Q

Early shock state presents with what acid base imbalance

A

Repritory alkalosis

28
Q

Which blood product does not need to be crossmatched before administration

29
Q

Electrical Alternan is define by what charterictics and what conditions does it present with

A

Alternated QRS complex amplitude or axis between beats and presents with cardiac tampande/pericardia effusion

30
Q

Becks triad is associated with what condition

A

Cardiac Tamponade

31
Q

Tension Pneumothorax presentation

A

Dyspnea, tachycardia, AMS, Narrowing pulse pressures, pulsus paradoxus (a decrease in BP upon inspiration), JVD, Hypotension, diminished breathsounds on affected side, shock, and cardiac arrest

32
Q

where to preform emergency needle thoracostomy

A

2nd ICS two finger widths lateral to the sternal border on the affected side (mid clavicular) should be incerted superior to the rib

33
Q

Kehr’s sign

A

Acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a preson is lying down. Left should pain is classical symptom of rupured spleen

34
Q

High voltage injuries are at what voltage
Low voltage injuries are at what voltage

A

> 1,000 volts
<1,000 volts

35
Q

Which current “freezes” the patient to the electrial source and has a higher likelihood of causing VF?

36
Q

Target urine output for electrical injury patient

37
Q

Cerebral perfusion pressure formula and normal value

A

MAP-ICP=CPP
70-90

38
Q

Normal ICP

A

0-10 anything greater than 20 is clinically signifcant

39
Q

Grey-Turner Sign presents with and indicates what

A

Bruising to the flank and indicates retroperitoneal or intra-abdominal bleeding
ususally takes up to 24-48 hours to show on assessment

40
Q

Define Hammans Sign and when is it found

A

Crunching sound auscultated on the anterior chest wall synchronized to the heart beat
Indicating Tracheobronchial injuries

41
Q

Burn patient urine target output

A

30-50 ml/hr
0.5-1 ml/kg/hr

42
Q

Hydrofloric acid should be flushed with what

A

Water and a calcium gluconate gel

43
Q

Management of the brain herniation includes after airway and breathing

A

Serum sodium goal of 155
serum os less than 320
Hypertonic saline, mannitol

44
Q

When should an escarotomy be consitered

A

Circumferential burns to the chest that decreases chest wall compliance

45
Q

Most common cause of PEA in the trauma patient

A

Hypovolemia

46
Q

Treatment of the cyanide patient

A

Amyl nitrite followed by sodium nitrite followed by sodium thiosulfate
Hydroxocobalamin

47
Q

Target urine output in the burn patients
Neonate
Pediatric
Adult
rhabdo/electrical burns

A

neonate 2ml/kg/hr
pediatric 1ml/kg/hr
adult 0.5 ml/kg/hr
rhabdo/electrical burns 2 ml/kg/hr

48
Q

ICP reducing agents

A

Mannitol and hypertonic saline

49
Q

HTN management in the neuo patient (ischemic/hemorrhagic stroke)

A

Labetalol 10 mg IVP
Nicardipine 5-15 mG/hr is a follow up

50
Q

What is REBOA

A

Resuscitative endovascular balloon oxxlusion or the Aorta
Indicated in severe shock secondary to exsanguination to occlude above the site of injury to eliminate bleeding as a bridge to surgery.
Dont use zone II

Critical Care (13 decks)

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