What are the two goals of providing basic life support (BLS)?
What is prevent hypoxia and hypercarbia
100
What is CLASS I hemorrhage according to ACS?
The volume of blood lost WITHOUT hemodynamic compromise. Usually <15% loss of circulating volume
100
What are the clinical signs of NEUROGENIC SHOCK?
What is HYPOTENSION and BRADYCARDIA
100
Which clotting factors are present in FFP?
What is FACTORS 5, 8, fibrinogen
100
Name the #1 cause of transfusion related mortality
What is TRALI
200
Name 2 of the 3 important aspects of AIRWAY MANAGEMENT in initial trauma evaluation
1. need for basic life support
2. presume c/spine injury
3. potential for difficult intubation
200
In patient with severe TBI, where should you try to maintain their ICP and CPP?
What is ICP <20 mmHg, CPP 50-70mmHg
200
T.B. is a 19y/o with a gsw to the leg, SBP 110, HR 125 and negative FAST scan in ER. What is this patient's ABC SCORE?
2
200
How do you estimate TOTAL BURNED SURFACE AREA (TBSA) percentage?
What is Rule of 9s
200
Describe the difference between 1st and 3rd degree BURNS
1st: no penetration of the epidermis
3rd: FULL THICKNESS of the dermis with injury to nerves, blood vessels and lymphatics
300
Your patient is arousable to speech, localizes to pain and is making incomprehensible moans. What is the GCS?
What is 10
300
What is the preferred site for CENTRAL IV ACCESS in unstable trauma patient's and WHY?
What is SUBCLAVIAN VEIN - stented open in hypovolemia due to location between the clavicle and 1st rib
300
What is "BURN SHOCK"
What is decreased CARDIAC OUTPUT by 50% with 30 minutes of burn induced vasoconstriction. Leads to NORMOVOLEMIC HYPOPERFUSION
300
You intubate a trauma patient in the ER. Shortly after attachment to vent, patient's BP drops to 30/20 and HR increases to 140. Most likely diagnosis?
What is TENSION PNEUMOTHORAX
300
How are you going to assess ADEQUACY OF RESUSCITATION in a severely burned pediatric patient?
What is URINE OUTPUT at 1-2 ml/kg/hour
400
How does high HbCO2 levels affect the O2-Hb dissociation curve? What does that mean?
What is shift to LEFT and decreases O2 availability to tissues
400
A bleeding trauma patient who is unresponsive with a BP of 40/30 has likely lost how much blood? (approx.)
What is 40% of circulating blood volume. (CLASS IV hemorrhage)
400
Name 3 conditions that can contribute to SECONDARY BRAIN INJURY?
What is SBP<90, PaO2 < 60, PaCO2 > 50, hyperthermia
400
You bring and unstable patient from ER to OR for evacuation of ACUTE SDH. Where should you maintain ETCO2 during the case?
What is normal (35-40). Hyperventilation in acute TBI exacerbates neurologic ischemia leading to worse outcomes.
400
How would you INDUCE an unstable 28y/o GSW to abdomen coming to OR from ER for an exploratory lap?
Avoid propofol : Use etomidate/ketamine/scopolamine : Assume full stomach (RSI)
500
What is the mechanism of TXA (tranexamic acid) and describe its utility in trauma
TXA can be used within 1st 3 hours of major trauma to decrease risk of death from bleeding
500
Which TEG component gives you the most information about platelet function?
What is MAXIMUM AMPLITUDE
500
Describe FLUID MANAGEMENT of a 70kg patient with 50% TBSA THIRD DEGREE BURNS
Parkland or modified Brooke formula. Over 24 hours. Use ONLY CRYSTALLOID but avoid NORMAL SALINE.
500
Your ICU burn patient suddenly has increase AIRWAY PRESSURES, difficult ventilation and acute ANURIA. What's going on? What do you do?
Acute abdominal compartment syndrome. Call for help. Measure bladder pressure. Call surgery team. Board patient for emergency decompressive laparotomy.
500
You bring patient A to OR for emergent surgery. Patient has hx 30% TBSA 3rd degree burns 1 week ago. Ate regular diet one hour ago. Describe your induction
RSI, Avoid succinylcholine and use rocuronium for induction