Trauma Overview and Statistics Flashcards

presentation by ms. daniel that had a lot of the same stuff from shore's slides.

1
Q

What are the three “BIG” questions when it comes to trauma anesthesia?

A

awake / unconscious

stable / unstable

emergent / urgent

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2
Q

How is anesthesia different in a trauma? (5)

A
  • many unknowns
  • multiple injuries and mechanism of injuries
  • do not know if patient is in optimal health
  • often have no patient history
  • decreased preparation and evaluation time
    (remember: damage control surgery is a quick procedure, as opposed to definitive surgery)
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3
Q

If you have time to ask, the patient is awake, or there is a family member present, what questions should you ask? (5)

A
  • allergies
  • medications
  • anesthetic history
  • significant medical history
  • NPO status
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4
Q

What information should you get from the first responders / emergency department? (7)

A
  • access
  • blood products given / available
  • antibiotics given
  • allergies
  • pts ventilation status
  • pts circulatory status
  • pts mental status
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5
Q

In a trauma, you want to intubate early in these situations. (7)

A
  • apneic
  • poor ventilation or oxygenation
  • decreased or changing mentation
  • developing airway obstruction (stridor, snoring)
  • airway burns (soot in nares, singed hair)
  • shock
  • combativeness (a sign of hypoxia)
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6
Q

If the ETCO2 is low, what are some differential diagnoses? (4… just to name a few)

A
  • shock
  • low cardiac output
  • PE
  • venous air embolus
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7
Q

When you are getting ready to induce your trauma patient, which is more important, the drug you choose or the dose of a given drug?

A

the dose that is given is more important than which drug you pick

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8
Q

Can you deliver oxygen without hemoglobin?

A

nope. well, not yet anyway.

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9
Q

PRBCs are concentrated to a Hct of about ___%.

A

75

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10
Q

Storing PRBCs (just above freezing) up to 42 days _______ the 2,3-DPG and _____ the platelets and neurtophils.

A

decreases

ruins

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11
Q

A unit of whole blood or packed red cells will raise the Hct by ___% and the Hgb by ___ gm/dL.

A

3%

1 gm/dL

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12
Q

FFP is used in bleeding patients with multiple coagulation factor deficiencies secondary to things such as? (3)

A
  • liver disease
  • disseminated intravascular coagulation (DIC)
  • dilutional coagulopathy resulting from massive blood or volume replacement
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13
Q

Four to eight packs of FFP in a 70-kg adult for each blood volume lost should be given over ___–___ min to achieve a minimum of ___% of plasma factor concentration.

A

90-120 minutes

30%

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14
Q

One random unit of platelets will raise the platelet count in an adult by _____-_____/cumm

A

5,000-8,000

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15
Q

In children, ___-___ units/kg will increase the platelet count by _____-_____/cumm

A

0.1-0.2 units/kg

30,000-50,000

(The expected increase will be less if the patient has sepsis, splenomegaly, platelet auto- or allo- antibodies or is receiving chemotherapy)

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16
Q

What would you do to treat hypertension in a trauma patient? (3)

A
  • increase anesthesia
  • esmolol
  • nitroglycerin

(if antihypertensives are used, it is highly advisable to use the short acting variety)

17
Q

Acidosis can shift the oxyhemoglobin dissociation curve to the _____.

A

right

18
Q

Is it generally indicated to give bicarb if the pH is > 7.25?

A

nope

19
Q

Cryoprecipitate was developed and used for the treatment of ________ __ and ___ ________.

A

hemophilia A

von Willebrands

20
Q

What three things does cryoprecipitate have in abundance?

A
  • fibrinogen
  • von Willebrand-factor / VIII complex
  • fibrin stabilizing factor / XIII
21
Q

Is cell saver blood considered whole blood?

A

nope, it’s like PRBCs

22
Q

At the end of a trauma case, or any case for that matter, what should we remember about the ABCs?

A

airway

  • can we extubate?
  • adequate reversal?

breathing

  • acidosis corrected?
  • narcotic requirements?

circulation

  • is the pt stable for transport?
  • is bleeding under control?