Flashcards in Trauma Overview and Statistics Deck (22)
What are the three "BIG" questions when it comes to trauma anesthesia?
awake / unconscious
stable / unstable
emergent / urgent
How is anesthesia different in a trauma? (5)
- 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)
If you have time to ask, the patient is awake, or there is a family member present, what questions should you ask? (5)
- anesthetic history
- significant medical history
- NPO status
What information should you get from the first responders / emergency department? (7)
- blood products given / available
- antibiotics given
- pts ventilation status
- pts circulatory status
- pts mental status
In a trauma, you want to intubate early in these situations. (7)
- poor ventilation or oxygenation
- decreased or changing mentation
- developing airway obstruction (stridor, snoring)
- airway burns (soot in nares, singed hair)
- combativeness (a sign of hypoxia)
If the ETCO2 is low, what are some differential diagnoses? (4... just to name a few)
- low cardiac output
- venous air embolus
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?
the dose that is given is more important than which drug you pick
Can you deliver oxygen without hemoglobin?
nope. well, not yet anyway.
PRBCs are concentrated to a Hct of about ___%.
Storing PRBCs (just above freezing) up to 42 days _______ the 2,3-DPG and _____ the platelets and neurtophils.
A unit of whole blood or packed red cells will raise the Hct by ___% and the Hgb by ___ gm/dL.
FFP is used in bleeding patients with multiple coagulation factor deficiencies secondary to things such as? (3)
- liver disease
- disseminated intravascular coagulation (DIC)
- dilutional coagulopathy resulting from massive blood or volume replacement
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.
One random unit of platelets will raise the platelet count in an adult by _____-_____/cumm
In children, ___-___ units/kg will increase the platelet count by _____-_____/cumm
(The expected increase will be less if the patient has sepsis, splenomegaly, platelet auto- or allo- antibodies or is receiving chemotherapy)
What would you do to treat hypertension in a trauma patient? (3)
- increase anesthesia
(if antihypertensives are used, it is highly advisable to use the short acting variety)
Acidosis can shift the oxyhemoglobin dissociation curve to the _____.
Is it generally indicated to give bicarb if the pH is > 7.25?
Cryoprecipitate was developed and used for the treatment of ________ __ and ___ ________.
What three things does cryoprecipitate have in abundance?
- von Willebrand-factor / VIII complex
- fibrin stabilizing factor / XIII
Is cell saver blood considered whole blood?
nope, it's like PRBCs