Show:
SHOCK
AKI
PULMONARY
COAGULATION
TRAUMA
100
Type of shock 27-year-old fall to the ground after walking out of the hospital cafeteria. Somnolent and unresponsive to command, with noisy breathing and a barely palpable radial pulse. temperature is 37.2°C (98.9°F), HR is 132/min, BP is 58/34 mm Hg, RR is 28/min, and Spo2 is 92%, Exam flushed skin in respiratory distress some l wheezing
What is anaphalactic/distributive shock
100
severe AKI with the need for renal replacement therapy.
What is ARF
100
Name of current Definition for ARDS
What is the Berlin Definition (2012)
100
s/p emergent decompression of a right temporal subdural hematoma. Pt loss aprox 1 L of blood from a scalp laceration pre-op, and lost at least another 1 L intraoperatively. He was given 8 units of (PRBCs), 6 FFP and 6 units of platelets. He remains hypotensive (80/40 mm Hg) on dopamine ( 10 µg/kg/min.) HR is 100/min and central venous pressure is 18 mm Hg. Medication to improve hypotension
What is calicum chloride (2g)
100
Injury in A 23-year-old man s/p mvc head on. Unrestrained and used cocaine within the previous hour. Diaphoretic and diaphoresis and reports abdominal and back pain. His initial BP is 80/40 mm Hg, with HR of 100/min. TLC placed, 500-mL bolus of normal saline solution brings his BP to 160/80 mm Hg and his HR to 80/min. W/in 15 minutes, BP 60/30 mm Hg HR 120 , cvp 9 mm Hg, he becomes unresponsive.
What is splenic laceration
200
Pt in VF. The initial end-tidal carbon dioxide partial pressure (Petco2) is 10 mm Hg during the initial chest compressions. After epinephrine, 1 mg, and defibrillation, the Petco2increases to 35 mm Hg to indicate
What is return of spontaneous circulation
200
Current classification of AKI 1. Increase serum creatinine by 0.3mg/dL or more within 48 hours or 2.Increase in serum creatinine to 1.5 times baseline or more within the last 7 days or 3.Urine output less than 0.5 mL/kg/h for 6 hours
What is KDIGO classsification: Kidney Disease Improving Global outcome
200
Recommended treatment course (days) for VAP
What is 7 days
200
Trial to assess the use of THE USE OF TRANEXAMIC ACID in acute bleeding
What is the CRASH Trial.
200
Injury that can lead to death by: Pain and Loss of tidal volume Paradoxical movement of chest wall Increase in intrapulmonary Shunt and V/Q mistmacth Pneumonia
What is rib fracture/flail chest
300
Class of shock on a motorcyclist with multiple Large contusions over left hemithorax and right abdomen, and left femur placed in a traction splint. 1.5 L NS en route. He is somnolent, and when roused, he is confused. HR is 120/min, BP is 97/74 mm Hg, RR is 32/min, and Spo2 is 93% On NRB. ? EBL at least 1 L of blood on the field. His left hemithorax is dull to percussion.
What is class III shock
300
Trial indicating Albumin is safe, but no more effective than isotonic saline for fluid resuscitation No difference in need for and duration of RRT
What is SAFE Trial
300
Contraindications for us includes: Cardiac or Respiratory arrest MSOF Facial trauma Upper airway obstruction Neurologic status High risk for aspiration
What is Non-Invasive positive pressure ventilation
300
An inactivated combination of factors II, IX, and X, with variable amounts of factor VII. Recommend the use of PCC in the setting of life-threatening bleeds primarily Warfarin toxicity
What is Prothrombin complex concentrate (PCC)
300
Clinical presentation of Large sub-cutaneous emphysema/pneumomediastinum Persistent large air leak following chest tube placement
What is Tracheobronchial tree injury
400
Respiratory rate Mental status Systemic Blood pressure
What are the Q sofa variables: Need to assess organ dysfunction in sepsis
400
Definition of change in the chloride concentration in the distal tubule lumen which may play a role in reducing the glomerular filtration rate.
What is Hyperchloremic Metabolic acidosis
400
Level A recommendation for ARDS
What is Low tidal-volume
400
Method of testing coagulation: a small sample of blood is taken and through 4º 45',(6x/min), to imitate sluggish venous flow and activate coagulation. A thin wire probe is used to measure, which the clot forms around. The speed and strength of clot formation is measured. The speed at which the sample coagulates depends on the activity of the plasma coagulation system, platelet function, fibrinolysis and other factors
What is Thromboelastography (TEG)
400
Most common dysrhythmia in blunt cardiac injury (BCI)
What is sinus Tachycardia
500
Pressor of choice for patient in septic shock after 5 liters of NS AND no urine output, BP 76/42, HR 132
What is norepinephrine
500
Severe Hyperkalemia Clinically apparent signs of uremia Severe acidemia Volume overload
What is absolute indication of RRT
500
Change in stress that occurs with each breath, difference in plateau pressure and PEEP
What is the driving pressure
500
These maneuvers are known as: Low resuscitation volume- Less acidemia from NS Shorter OR time -less exposure to cold environment Less Factor Dilution- Less Hemorrhage
What is Permissive Hypotension (prevention of lethal triad)
500
Cardiac physiologic response of abdominal compartment pressure that affects cardiac output
What is decrease in Stroke volume