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Flashcards in Test #2 Trauma overview-Josh Deck (49)
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1

b/t the ages of ___ to ____ trauma kills more people than any other disease or illness

birth to 30

2

Trauma Systems:

what are the 4 main systems that treat traumas?

  • prevention
  • First responders
  • Acite care- Trauma Centers
  • Post- trauma care/ rehabilitation

3

Trauma Systems: Prevention

What are 3 main ways prevention is provided?

Education

Laws

Highway safety

4

Trauma Systems: First responders

What are 3 ways first responders aid in trauma prevention/decrease mortality w/ traumas

Shorter response times

Well educated rescuers

Life flights

5

Trauma Systems: Trauma Centers

what are the differnet levels

I and II

6

Trauma Systems: Trauma Centers

whichh level is a comprehensive regional resource that is a tertiary care facility central to the trauma system. And is capable of providing total care for every aspect of injury from From PREVENTION to RECOVERY

Level I

7

Trauma Systems: Trauma Centers

what are the elements of a Level I

  • 24hr inhouse general surgeon and Prompt availablility of specilties (ortho, neuro, anesthesia, ER, radiology, peds, critical care, etc)
  • Referal resource for communnities in nearby regions
  • Leadership in prevention, public education
  • PROVIDES CE OF THE TRAUMA TEAM MEMBERS
  • comprehensive quality assessment program
  • teaching and research in trauma
  • Programs for substance abuse
  • Meets minimum req for annual volum eof severely injured pts

8

Trauma Systems: Trauma Centers

a Level ____ is able to initiate definative care for all injured pts

II

9

Trauma Systems: Trauma Centers

whata are the elements of a level II

  • 24 hour immediate coverage by general surgeons as well as specialties
  • Tertiary care needs such as cardiac sx, hemodyalysis and microvascular may be refered to a level I
  • provides trauma prevention and CE programs for staff
  • Incorporateds comprehensive Quality assessment program

10

Emergent Vs Urgent

Awake and stable

Emergent

11

Emergent Vs Urgent

unconscious or unstable

Urgent

12

what makes trauma anesthesia so different?

  • Many unknowns
  • Multiple injuries and mechanisms of injuries
  • Pt's health status unk
  • No pt hx
  • Decreased prep and evluation time

13

Trauma anesthesia:

the amount of pt info you gather preop is largely dependent on what?

 

the stability of the pt

14

Trauma anesthesia:

what are the main questions you must obtain from the trauma center?

  • Access
  • Blood products given/ avail
  • Abx given
  • Allergies
  • Pt's ventilation/circulation/ mental status

15

Trauma anesthesia:

questions you want to ask the pt or pt's family

  • Allergies
  • medications
  • Anesthesia hx
  • Significant medical hx
  • NPO status

16

Trauma anesthesia: Airway

what are 7 main conditions that require early intubation

  • Apnenic
  • Poor ventilation
  • Decreased/ Changing mentation
  • Devleoping airway obstruction (stidor/snoring)
  • Airway burns (soot in nares, singed hair)
  • Shock
  • combativness

17

Trauma anesthesia: Breathing

what are some ventilation management factors?

  • Location of incision
  • Hemnodynamic compromise
  • Presence of lung injury

18

Trauma anesthesia: Breathing

what is a big choice you must answer prior to tube placement

DLT or NO DLT

19

Trauma anesthesia: Breathing

if EtCO2 is low, don't forget to differentially diagnose the cause. what are some of the causes

  • Shock
  • Low CO
  • PE
  • VAE

20

Trauma anesthesia: Circulation

what are your fluid choices for hemodynamic stability?

  • Crystalloid
  • Colloid
  • Blood

21

Trauma anesthesia: Circulation

what are the 3 main accesses you need to get

Large IVs

Central Lines

A-line

22

Trauma anesthesia: Management

what are 3 different ways to administer anesthesia

 

GETA

Regional

MAC

23

Trauma anesthesia: Management

w/ induction agents whats more important? the agent or the dose?

Dose

24

Trauma anesthesia: Management

what are some good induction drugs?

  • Etomadate
  • Ketamine
  • STP
  • Propofol

25

Trauma anesthesia: Management

what are 4 main complications you can run into

Bleeding

Hypoxia

Acidosis

Hypothermia

26

Trauma anesthesia: Management

what are 2 big post-op concerns?

Do we extubate?

ABCs

27

 

Trauma anesthesia: Management

what are 6 treatments for hypotension

 

  • Allow time
  • crystalloid/colloid
  • PRBC's
  • FFP
  • Platelets
  • Pressors

28

Trauma anesthesia: Management

PRBC's are concentrated to a Hct of about ___% and a volume of ___mLs

75%

200mLs

29

Trauma anesthesia: Management

storig PRBC's (just above freezing) up to ___days decreases the 2,3-DPG and ruins the platelets and neutrophils

42 days

30

Trauma anesthesia: Management

____ are the fastes way to increase the O2 delivering capacity of the blood

PRBCs