Trauma/Burn Flashcards
1
Q
Consensus formula for burn resuscitation
A
% TBSA burn x weight in kg x 2 (24 hour total)
calculated initiaal rate based on receiving 1/2 in first 8 hours
Titrated down or up based on UOP, goal 30-50 cc/hr with hourly titration up or down of 20%.
2
Q
Dianogsis and treatment of inhalation injury
A
- Enclosed space, soot around airways
- ABG looking for CO
- 100% supplemental O2 by facemask
- Intubation for airway compromise
- Bronchoscopy for diagnosis and treatment if intubated
- Nebulized mucomyst and heparin albuterol
- Hydroxycobalamin if concerned about CN poisoning. (acidosis, lactate, or resistant hypoxemia)
3
Q
Treatment of large 3rd degree burn
A
- Resuscitation and topical antimicrobial
- Excision within 24 hours for TBSA > 30%
- Watson blade for large areas, Weck blade for hands
- 3:1 STSG or
- Keep immobilzed for 48 hours
- Dressing down in 5 days
4
Q
Upper GI bleed after bad liver trauma
A
hemobilia, needs IR embolization.
5
Q
Baseline energery requirements
A
30 kcal/kg/d multiplied by stress factor
6
Q
Protein requirements per day
A
1 g/kg/day
7
Q
side effects of three topical agents
- Silvadene
- Sulfamylon
- Silver nitrate
A
- neutropenia
- metabolic acidosis
- hyponatremia/hypochloremia
8
Q
Treatment of amiodarone induced thyrotoxicosis (type I and II)
A
- Hyperthyroidism (thionamides), radioiodine, possible total thyroidectomy (stop amio too obviously)
- Destructive thyroiditis; high dose steroids, possible total thyroidectomy
9
Q
Types of rectus sheath hematomas and their treamtent
A
- Type I: doesn not cross midline. within the rectus sheath: compression, anticoagulation reversal
- Type II: below the arcuate line. Can cross midline. Above treatment if stable, otherwise angioembolization or surgery
- Type III: space of retzius. Can be intraperitoneal. If stable, conservative management. If not, then angioembolization or surgery
