Labs
Normal Na level
135-145
Normal ICP
<10
Normal CVP
2-8
How much urine on a bladder scan warrants an I/O cath?
>300
How long is your tubing good for?
72 hours
Two meds given for increased ICP and their doses
3% - 250-500cc
mannitol - 50-100g
1st and 2nd line drugs for septic shock
Norepinephrine and vaso
What are 'minimals' on the vent?
30% 5 peep and 5 of PS
Labs you would draw with MTP
Fibronigen, BMP, CBC
How do you calculate CPP
Map - ICP = CPP
What is a contraindication for giving Neo?
bradycardia
Greater than 10 of levo or otherwise specified in order
How often do we change propofol tubing?
every 12 hours
levo - 0-30mcg with hard max of 50 mcg
neo- 0-300
What order do you give RSI medications?
Sedation first, then paralytic
How often do you complete mouth care on intubated patients?
every 4 hours
Hemoglobin <7 or symptomatic hypotension
What 3 things are included in cushing's triad
1. bradycardia
2. widened pulse pressure
3. irregular respirations
What labs and/or tests are indicated for blunt cardiac injury?
Troponin, EKG, Echo
Normal intra-abdominal pressures? Where do you level?
<20 and iliac crest
What is preferred access between PIV and CVC?
CVC
What medication would we use to decrease BP
Nicardipine
When MTP'ing, what is the preferred access for infusion?
Atleast 18 gauge or bigger PIV or central line without clave (distal port)
For new trachs, when can you
1. change the dale collar and inner cannula?
2. take the sutures out?
3. how often is trach care?
1. 24 hours on dale collar and inner cannula is immediate and/or prn
2. 48 hours
3. once a shift or as needed
What labs do we order when patient has a crush injury?
CPK, BMP, lactate
What is the difference between Codman and EVD?
EVD is a drain without continuous monitoring and codman has no drain and continuously monitors ICP
During MTP what electrolyte do we replace and why?
Calcium
Patient returns from OR in discontinuity, when do we start tube feeds?
not until back in continuity
What central line would you use with a PA cath?
MAC
You are maxed on 2 pressors, where do you obtain your glucose check from?
BP - 170/110
HR - 130
T - 101.9
Your patient is post op day 5 from a PSF. They are agitated and diaphoretic. What is this called?
autonomic dysreflexia
What mode do we place a patient in before sedating and paralyzing?
SIMV
Why would we order a urine specific gravity on a patient?
Testing for DI
GCS Motor Scale
6 - obeys commands
5 - localizes
4 - withdraw
3 - flexion
2 - extension
1 - none
Name this shock:
CVP - 12
BP - 79/45 (56)
HR - 140
CO/CI - 3/1.2
PAP - 69/33
SVR - 2500
Cardiogenic
What injuries are indicated when you find blood at the meatus?
pelvic fratures and bladder injuries
What do we use the red/blue ports on a vascath for?
dialysis only
Standard concentration for levophed
8mg in 250 ml
What is the trauma triad?
coagulopathy, hypthermia, and acidosis
diamond - includes hypocalcemia
ph - 7.35
c02 - 59
p02 -71
bicarb - 33
fully compensated respiratory acidosis