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Flashcards in Trauma Overview and Statistics Deck (22)
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1

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

awake / unconscious

stable / unstable

emergent / urgent

2

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)

3

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

- allergies

- medications

- anesthetic history

- significant medical history

- NPO status

4

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

- access

- blood products given / available

- antibiotics given

- allergies

- pts ventilation status

- pts circulatory status

- pts mental status

5

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

- 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)

6

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

- shock

- low cardiac output

- PE

- venous air embolus

7

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

8

Can you deliver oxygen without hemoglobin?

nope. well, not yet anyway.

9

PRBCs are concentrated to a Hct of about ___%.

75

10

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

decreases

ruins

11

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

3%

1 gm/dL

12

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

13

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.

90-120 minutes

30%

14

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

5,000-8,000

15

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

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)

16

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

- increase anesthesia

- esmolol

- nitroglycerin

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

17

Acidosis can shift the oxyhemoglobin dissociation curve to the _____.

right

18

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

nope

19

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

hemophilia A

von Willebrands

20

What three things does cryoprecipitate have in abundance?

- fibrinogen

- von Willebrand-factor / VIII complex

- fibrin stabilizing factor / XIII

21

Is cell saver blood considered whole blood?

nope, it's like PRBCs

22

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

airway
- can we extubate?
- adequate reversal?

breathing
- acidosis corrected?
- narcotic requirements?

circulation
- is the pt stable for transport?
- is bleeding under control?