resuscitation phase pt 2

Question 1

Most common cause of hypotension and impaired CO in trauma?

Answer 1

Hypovolemic shock from acute blood loss

Question 2

What causes hypovolemic shock?

Answer 2

External or internal hemorrhage.

Question 3

What is the first intervention for external bleeding?

Answer 3

Apply pressure to stop bleeding.

Question 4

What must be done before suturing or cauterizing a bleeding wound?

Answer 4

Stop the hemorrhage first.

Question 5

What is the purpose of FAST exam?

Answer 5

Rapid, non-invasive test to detect blood or free fluid in abdomen or pericardium.

Question 6

What organs/areas does FAST evaluate?

Answer 6

Abdomen, kidneys, liver, heart.

Question 7

What happens if FAST is positive?

Answer 7

CT scan and/or surgical intervention.

Question 8

What cardiac tests may be ordered?

Answer 8

ECHO, 12-lead ECG, continuous ECG with ST monitoring.

Question 9

Why monitor the heart after trauma?

Answer 9

Stress and trauma can induce MI.

Question 10

What size IVs are used for fluid resuscitation?

Answer 10

Two large-bore IVs (20 gauge or higher).

Question 11

Preferred IV locations?

Answer 11

Antecubital or forearm.

Question 12

When is a central line needed?

Answer 12

For ongoing resuscitation or poor peripheral access.

Question 13

What catheter measures response to fluids?

Answer 13

Pulmonary artery (PA) catheter.

Question 14

What is the preferred initial fluid?

Answer 14

Normal saline.

Question 15

What is the 3:1 rule?

Answer 15

3 mL of fluid per 1 mL of blood lost.

Question 16

What are the types of fluid responders?

Answer 16

Rapid, transient, minimal responders.

Question 17

What is done if fluid resuscitation fails?

Answer 17

Blood transfusion.

Question 18

What complications can excessive fluids cause?

Answer 18

Dilutional coagulopathy, third spacing.

Question 19

How do you recognize dilutional coagulopathy?

Answer 19

Blood draw appears pink (overdiluted).

Question 20

What temperature defines hypothermia?

Answer 20

<35°C (95°F).

Question 21

Why do trauma patients get hypothermic?

Answer 21

Accelerated heat loss & decreased heat production; massive blood loss; alcohol; fluid resuscitation.

Question 22

Why are older adults more susceptible to hypothermia?

Answer 22

Decreased physiologic reserve.

Question 23

Complications of hypothermia?

Answer 23

Coagulopathy, myocardial dysfunction, dysrhythmias, ↓metabolic rate.

Question 24

Environmental considerations during resuscitation?

Answer 24

Warm room, warm fluids, prevent heat loss.

Question 25

What else should be done regarding wounds?

Answer 25

Clean, debride, and initiate antibiotics.