Trauma - Special Populations

Question 1

pediatric - hemorrhage

Answer 1

• first signs is tachycardia

- hypotension and decreased UO are late signs (>30% blood loss)

Question 2

pediatric - fluid bolus

Answer 2

• crystalloid: 20 mL/kg

- colloid: 10 mL/kg

Question 3

obstetric - radiation exposure

Answer 3

< 5 rad (50 mGy) does not cause fetal anomalies, growth restriction or pregnancy loss.

Question 4

placental abruption - S/S

Answer 4

-vaginal bleeding
-preterm labor
-abdominal pain
-coagulopathy
uterine tenderness

Question 5

placental abruption - treatment

Answer 5

• detachment of placenta from uterine wall
• deliver baby
• resuscitate mother

Question 6

uterine rupture - S/S

Answer 6

• pain
• shock
• abdominal distention
• palpable fetal parts
• fetal distress

Question 7

uterine rupture

Answer 7

• high mortality (~100%fetal mortality, 10% maternal)
• emergent C-section
• resuscitate mother

Question 8

ACLS and obstetric

Answer 8

*if ACLS is unsuccessful and mother is pregnant > 20 weeks, emergent C-section is indicated for improved survival for mother

Question 9

obstetric airway

Answer 9

• respiratory alkalosis

- increased aspiration risk

Question 10

obstetric circulation

Answer 10

• increase in blood volume
• physiologic anemia
• increased HR, CO, decreased SBP, DBP
• supine hypotension after 20 weeks
• increased risk for DIC

Question 11

What is SCIWORA?

Answer 11

spinal cord injury without radiographic abnormality bc don’t see cartilage

Question 12

Rho (D) immune globin

Answer 12

needs to be given to all Rh-negative pregnant women within 72 hours of trauma