Term
| what arterial waveform indicates your pt is hypovolemic? |
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Definition
| an increased baseline with inspiration |
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Term
| ATLS advocates administering a certian amount of crystalloid up to 2 times in your shock pt, then if symptoms persist move on to blood, how much crystalloid do you replace prior to moving on to your blood? |
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Definition
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Term
| other than type O neg, what other blood type can you give to a pt without a crossmatch? |
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Definition
| type O positive if they are out of childbearing age (>55 y/o) |
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Term
| if you give more than _________ units of uncrossed blood, you need to continue this blood or get a new type and cross for the pt |
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Definition
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Term
| base deficit of 2-5= ________ hypovolemia, 6-14 ______________, >14 ___________ |
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Definition
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Term
| how long do your lactate and base deficit values accurately depict fluid resuscitation? Why? |
|
Definition
| 12-16 hours, because the liver and kidney retain/influence your bicarb levels |
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Term
| what adequate urine output levels depict adequate fluid resuscitation? |
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Definition
| >2ml/kg/hr in an infant, >1.5 in a young child, >1 in an older child, >.5 in an adult |
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Term
| name some good determinants of adequate fluid resuscitation in your trauma pt.... |
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Definition
| lactate less than 2, base deficit <3, normal ph, adequate u/o, normal svo2, normal vitals, improving LOC or sensorium, improving cap refill and extremity temp |
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Term
| when should u use bicarb in trauma? |
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Definition
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Term
| what can acidosis cause in your trauma pt? |
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Definition
| myocardial depression, arrhythmias, coagulopathies, hypotension |
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Term
| in your bleeding shok pt, what coagulopathic event occurs first? |
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Definition
| dilutional thrombocytopenia |
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|
Term
| how much FFP should you give your shock pt per 10 units of PRBC? |
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Definition
| 2-4 units, gayle says we should treat as early as 4-6 units of prbcs |
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Term
| what does auto transfused blood lack? |
|
Definition
| coag factors and platelets |
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Term
| are Pt/PTT, fibronigen, FDP, d-dimer and platelets low or normal in DIC? |
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Definition
| all low (positive ddimer and high FDP), this is not true for thrombocytopenia (only platelets are low) |
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Term
| what percentage of trauma pts survive if they have a T < 32C? |
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Definition
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|
Term
| at what temp do coag factors cease to function? |
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Definition
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Term
| are bair huggers and a warm OR good for treating your hypothermic trauma pt? |
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Definition
| no, they are good for prevention, rapid infusion of warm fluids and warm gastric lavage (and bypass) are good treatment measures |
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