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Advanced Principles B (Summer '24) > Trauma Anesthesia (Exam II) > Flashcards

Trauma Anesthesia (Exam II) Flashcards

1
Q

What is the “Lethal Triad” associated with hemorrhage?

A
  • Hypothermia
  • Metabolic Acidosis
  • Coagulopathy
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2
Q

Resuscitation using ________ increases blood loss, transfusion requirements, and mortality.

A

Crystalloids

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3
Q

What is Class I Hypovolemic Shock?

A

15% blood loss, normal vitals

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4
Q

What is Class II Hypovolemic Shock?

A
  • 15 - 30% blood loss
  • ↑ HR
  • Normal sBP
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5
Q

What is Class III Hypovolemic Shock?

A
  • 30 - 40% blood loss
  • ↓ BP
  • ↓ mentation
  • HR > 120
  • Delayed capillary refill
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6
Q

What is Class IV Hypovolemic Shock?

A
  • > 40% blood loss
  • ↓BP w/ narrowed pulse pressure
  • Absent UO
  • Significantly altered mentation
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7
Q

Components of the GCS.

A

12 - 15: sick but okay
8 - 12: needs help
< 8: bad

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8
Q

Components of damage control resuscitation.

A
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9
Q

What are the two things we are concerned about with crystalloid over-resuscitation?

A
  • Abdominal Compartment Syndrome
  • Hemodilution
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10
Q

What is the order of crystalloid preference for trauma patients?

A
  1. Plasmalyte
  2. LR
  3. NS
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11
Q

What are the early and late effects of shock on the renal system?

A
  • Early: GFR maintained
  • Late: ATN, inability to concentrate urine
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12
Q

What is one of the earliest organs effected by shock? Why?

A

Intestines due to blood being shunted away to more vital organs

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13
Q

Which organ metabolizes citrate?

A

Liver

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14
Q

What is the classic trauma dose of TXA?

A

2g IV bolus

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15
Q

What is the pediatric dose of TXA?

A

15mg/kg bolus
2mg/kg/hr over 8 hours

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16
Q

What two things in trauma patients result in decreased citrate metabolism?

A
  • Hypothermia
  • Liver injury
17
Q

Compare whole blood to a PRBC:FFP:PLT:Cryo combination.

A
18
Q

What is REBOA?

A

Resuscitative Endovascular Balloon Occlusion of the Aorta.

19
Q

What are contraindications to REBOA?

A

Pericardial Tamponade & Aortic Dissection

20
Q

Does REBOA work?

A
21
Q

Compare mild, moderate, and severe TBI.

A
22
Q

Epidural hematomas are most often caused by injury to the….

A

middle meningeal artery

23
Q

What is the classic “sign” associated with epidural hematoma?

What other signs are there?

A

LOC → consciousness → LOC (Lucid Interval)

  • Mydriasis
  • ↓ HR
24
Q

“Lucid Interval” is commonly associated with…..

A

Epidural Hematomas

25
Q

Subdural hematomas are typically due to a tear in the….

A

Sagittal venous sinus

26
Q

What s/s are common with a subdural hematoma?

A
  • Headache
  • Progressive drowsiness
  • Visual issues
  • Gait issues
27
Q

What PaCO₂ is typically needed to induce brain relaxation?

A

PaCO₂ of 30 - 35 mmHg

Can intermittently hyperventilate to 25 if necessary.

28
Q

Differentiate complete and incomplete spinal cord injuries.

A
29
Q

What are the 5 “P’s” of acute compartment syndrome?

A
  • Pallor
  • Paralysis
  • Paresthesia
  • Pain
  • Pulselessness
30
Q

What long bone fracture is compartment syndrome most common with?

A

Tibia

31
Q

What is the triad associated with pericardial tamponade?

A

Beck’s Triad

  • Hypotension
  • Muffled Heart tones
  • Distended neck veins
32
Q

A sBP goal of _____ if bleeding is non-compressible.

A

90 mmHg

33
Q

Where are the 4 areas of the body where non-compressible bleeding can occur?

A
  • Abdomen
  • Chest
  • Brain
34
Q

What 3 areas of the body are semi-compressible or difficult to compress?

A
35
Q

What is the ET-Tube size formula for pediatric patients older than two years?

A

(Age + 16) ÷ 4

36
Q

What is the formula for determining what depth an ETT should be placed at in a pediatric patient (cm)?

A

(Age ÷ 2) + 12

Advanced Principles B (Summer '24) (8 decks)

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