Emergency Medicine: Blood Loss and Burns Quiz
49 Questions
32 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What defines major haemorrhage in terms of blood loss in a 70kg male?

  • 5 liters in less than 24 hours
  • 50% blood volume in less than 3 hours
  • Bleeding more than 150ml/min
  • All of the above (correct)

Which statement about the coagulopathy component of the lethal triad is accurate?

  • Loss of red blood cells and clotting factors impacts clotting. (correct)
  • TXA enhances clotting enzyme activity.
  • Fibrinolysis occurs after clot formation without any exceptions.
  • Microclots are beneficial and not broken down.

What is the role of calcium in the clotting cascade?

  • It directly breaks down fibrin.
  • It initiates the extrinsic pathway.
  • It enhances the production of platelets.
  • It is essential for activating clotting factors. (correct)

What is a potential consequence of administering large volumes of FFP?

<p>Transfusion-associated circulatory overload (TACO). (D)</p> Signup and view all the answers

In a situation of significant haemorrhage, what treatment should be prioritized?

<p>Control of bleeding and blood volume replacement. (B)</p> Signup and view all the answers

Which of the following is true regarding FFP and cryoprecipitate?

<p>FFP contains all clotting factors including fibrinogen. (C)</p> Signup and view all the answers

What characterizes a 3rd degree burn?

<p>Full thickness with nerve destruction and no pain (B)</p> Signup and view all the answers

Which zone of injury involves maximum cell damage and death, leading to coagulation?

<p>Zone of coagulation (B)</p> Signup and view all the answers

What systemic response occurs when burns affect 30% of tissue areas?

<p>Release of catecholamines and decreased blood flow to regions (A)</p> Signup and view all the answers

Which of the following represents a primary metabolic change following a significant burn injury?

<p>Loss of volume leading to lactic acid buildup (B)</p> Signup and view all the answers

What is an essential aspect of respiratory management for burn patients?

<p>Mechanical ventilation may stabilize the airway (C)</p> Signup and view all the answers

What physiological process occurs rapidly in response to changes in pH?

<p>Respiratory compensation (D)</p> Signup and view all the answers

Which condition is indicated by an HCO₃⁻ level above 26 mmol/L?

<p>Alkalosis (C)</p> Signup and view all the answers

If the kidneys are not producing enough bicarbonate, what type of issue is likely present?

<p>Metabolic issue (D)</p> Signup and view all the answers

What is the normal range for Base Excess (BE) in a blood gas analysis?

<p>-2/+2 (D)</p> Signup and view all the answers

In mixed acid-base disorders, how do CO₂ and HCO₃⁻ behave?

<p>Move in opposite directions (C)</p> Signup and view all the answers

Which of the following indicates compensatory metabolic acidosis?

<p>A low HCO₃⁻ level with high CO₂ (D)</p> Signup and view all the answers

What likely caused the observed blood gas results in the case study example?

<p>Hyperventilation (D)</p> Signup and view all the answers

What is the primary characteristic of a Level 1 critical care patient?

<p>At risk of condition deteriorating, requiring acute ward support (D)</p> Signup and view all the answers

When analyzing blood gas results, which value is critical in assessing respiratory status?

<p>PaCO₂ levels (A)</p> Signup and view all the answers

Which type of equipment is essential for monitoring critically ill patients during transfer?

<p>Standardized airway management devices (D)</p> Signup and view all the answers

An increased acid load leads to which primary reaction in the body?

<p>Increased CO₂ + H₂O production (C)</p> Signup and view all the answers

In what situation would a patient be classified as Level 2 in critical care?

<p>Needs additional observation or intervention, possibly from ICU (A)</p> Signup and view all the answers

What is a crucial responsibility of an Operating Department Practitioner (ODP) in the transfer team?

<p>Communicate effectively with ICU personnel (A)</p> Signup and view all the answers

What indicates that a mixed acid-base disorder might be present?

<p>Changes in CO₂ and HCO₃⁻ move in opposite directions (B)</p> Signup and view all the answers

What does SBAR stand for in the context of handover?

<p>Situation, Background, Assessment, Recommendation (C)</p> Signup and view all the answers

Which statement is true regarding Level 3 critical care patients?

<p>They usually have complex multi-organ failure and need advanced support. (D)</p> Signup and view all the answers

What is one of the key pieces of equipment that a transfer team should prepare for critically ill patients?

<p>Standardized PPE for safety (D)</p> Signup and view all the answers

Which of the following best describes the role of the anesthetist during the transfer of critical patients?

<p>Assist in monitoring and managing the patient’s condition. (C)</p> Signup and view all the answers

What physiological change is indicated by decreased saturation in a patient?

<p>Risk of acidosis (B)</p> Signup and view all the answers

Which statement accurately describes the pharyngeal reflex?

<p>It protects against aspiration by causing muscle contraction. (D)</p> Signup and view all the answers

What is the primary function of the laryngeal reflex?

<p>Prevents foreign objects from entering the trachea (B)</p> Signup and view all the answers

How does general anesthesia (GA) affect airway reflexes?

<p>It suppresses brain activity inhibiting reflexes. (A)</p> Signup and view all the answers

Which anatomical feature of the right bronchus distinguishes it from the left bronchus?

<p>Wider and shorter (B)</p> Signup and view all the answers

What does the acronym BURP represent in airway management?

<p>Backwards Upwards Rightward Pressure (B)</p> Signup and view all the answers

Which structure serves to surround and support the vocal cords?

<p>Arytenoid cartilage (D)</p> Signup and view all the answers

What is the effect of local anesthesia (LA) on airway reflexes?

<p>Blocks sensory messages (D)</p> Signup and view all the answers

Which of the following describes the structure and function of the larynx?

<p>Protects vocal cords and facilitates sound (D)</p> Signup and view all the answers

What role does the vallecular space play in airway management?

<p>It is where the mac blade is used to lift the epiglottis. (C)</p> Signup and view all the answers

What is the primary role of the SA Node in the heart?

<p>Serves as the main pacemaker (D)</p> Signup and view all the answers

Which phase of the cardiac action potential is characterized by Na+ channels opening?

<p>Depolarization (Phase 0) (D)</p> Signup and view all the answers

What is indicated by the PR interval in cardiac rhythm?

<p>Delay in the AV node (B)</p> Signup and view all the answers

What happens to potassium (K+) during the early repolarization of a cardiac action potential?

<p>K+ channels close and K+ leaves the cell (D)</p> Signup and view all the answers

Which of the following statements accurately describes a cardiac cell at rest?

<p>Polarized state with a negative resting membrane potential (D)</p> Signup and view all the answers

What is the primary immunoglobulin responsible for the allergic response in anaphylaxis?

<p>Immunoglobulin E (IgE) (D)</p> Signup and view all the answers

Which of the following is NOT a symptom of Grade 2 anaphylaxis?

<p>Coughing (B)</p> Signup and view all the answers

What mechanism causes bronchoconstriction during an anaphylactic reaction?

<p>Histamine binding to smooth muscle receptors (D)</p> Signup and view all the answers

In severe systemic anaphylaxis, which cardiovascular condition is primarily associated with the release of histamine?

<p>Cardiovascular shock (A)</p> Signup and view all the answers

What treatment is typically administered first when a patient experiences anaphylaxis?

<p>Intramuscular adrenaline (epinephrine) (B)</p> Signup and view all the answers

Flashcards

Zone of Coagulation

The area of a burn where the most damage occurs, resulting in cell death and impaired circulation due to coagulation.

Zone of Stasis

The area surrounding the zone of coagulation where tissue perfusion is reduced, but cells may still be salvageable if treated promptly. If untreated, it can become irreversible and lead to complications like infection and edema.

Zone of Hyperemia

The outermost area of a burn where blood flow is increased due to inflammation. This is a natural response to injury.

Insulin Resistance in Burns

A dangerous condition characterized by a decrease in glucose uptake and clearance from the body, exacerbated by the release of adrenaline, leading to insulin resistance.

Signup and view all the flashcards

Lethal Triad in Burns

A group of critical complications that arise as a result of extensive burns. These include loss of volume (hypovolemia), loss of oxygen (hypoxia), and production of lactic acid (metabolic acidosis).

Signup and view all the flashcards

What is Anaphylaxis?

Anaphylaxis is a severe, life-threatening allergic reaction that causes a rapid drop in blood pressure, swelling of the airways, and potential cardiovascular collapse.

Signup and view all the flashcards

How does the immune system trigger Anaphylaxis?

IgE antibodies bind to mast cells, which release histamine and other inflammatory mediators upon exposure to the allergen, leading to the symptoms of anaphylaxis.

Signup and view all the flashcards

What are the main effects of histamine in Anaphylaxis?

Histamine causes blood vessels to dilate, leading to a drop in blood pressure (BP), muscle contractions in the airways (bronchospasm), and increased mucus production.

Signup and view all the flashcards

How is Anaphylaxis treated?

Emergency treatment for Anaphylaxis involves administering epinephrine (adrenaline), providing high-flow oxygen, and giving fluids to restore blood volume.

Signup and view all the flashcards

How does Anaphylaxis affect the cardiovascular system?

Anaphylaxis can affect the cardiovascular system by causing vasodilation, leading to a decrease in blood pressure and a reduced ability to transport oxygen throughout the body.

Signup and view all the flashcards

Major Haemorrhage

Losing 5 liters/70ml/kg of blood in less than 24 hours, or 50% of blood volume in less than 3 hours. Bleeding more than 150ml/min, heart rate above 110 bpm, and systolic blood pressure below 90mmHg.

Signup and view all the flashcards

Body's Response to Blood Loss

The body's natural response to blood loss involves the kidneys releasing water to maintain stable plasma levels and blood pressure, and the release of hormones to constrict blood vessels and increase vascular resistance.

Signup and view all the flashcards

Coagulopathy

A condition characterized by abnormal clotting cascade, loss of red blood cells and clotting factors, leading to ineffective clotting.

Signup and view all the flashcards

Fibrin Formation

The process of fibrinogen in the blood transforming into fibrin, a key protein in clot formation, activated by thrombin.

Signup and view all the flashcards

Fibrinolysis

The process of breaking down blood clots, often occurring during major haemorrhage.

Signup and view all the flashcards

Role of Calcium in Clotting

A crucial element in the clotting cascade, contributing to clotting by binding with calcium to stop clotting.

Signup and view all the flashcards

Level 0 Critical Care

A patient whose needs can be met on a regular ward, without requiring specialized critical care.

Signup and view all the flashcards

Level 1 Critical Care

A patient at risk of their condition worsening, requiring close observation and support from the critical care team, but not needing full ICU care.

Signup and view all the flashcards

Level 2 Critical Care

A patient requiring more intensive observation and intervention than Level 1, often with support for a single failing organ system. This level includes patients transitioning from ICU (High Dependency Unit).

Signup and view all the flashcards

Level 3 Critical Care

A patient needing advanced respiratory support and management of multiple organ failures, requiring intensive care (ICU).

Signup and view all the flashcards

Portable Monitoring

A portable device used to monitor vital signs (heart rate, blood pressure, oxygen saturation, etc.) during patient transfer.

Signup and view all the flashcards

Portable Ventilator

A device that provides mechanical ventilation to assist with breathing, capable of delivering oxygen and regulating pressure (PEEP, FiO2, I:E ratio).

Signup and view all the flashcards

SBAR Handover

The process of transferring information about a patient from one healthcare team to another, using a standardized format (Situation, Background, Assessment, Recommendation).

Signup and view all the flashcards

Transfer of Critically Ill

The set of procedures and equipment required for moving a critically ill patient, ensuring safe and effective transfer between care locations.

Signup and view all the flashcards

Low Saturation

The saturation of oxygen in the blood is low, which increases the risk of acidosis.

Signup and view all the flashcards

Beavals

Beavals are large, bulky patients with a thick neck, making it difficult to get a good seal with a face mask.

Signup and view all the flashcards

Cricoid Pressure

The cricoid cartilage is a complete ring, and when pressure is applied during a cricoid pressure maneuver, it occludes the esophagus.

Signup and view all the flashcards

Thyroid Cartilage

The thyroid cartilage is a hollow structure in the neck.

Signup and view all the flashcards

Tongue & Airway

The tongue is important for airway management, as its size and muscle tone can affect the airway.

Signup and view all the flashcards

Reflexes & Anesthesia

Reflexes are triggered by sensory nerves, sending messages to the brain to initiate protective motor movements. General anesthetics inhibit these reflexes.

Signup and view all the flashcards

Pharyngeal Reflex

The pharyngeal reflex is triggered by the vagus and glossopharyngeal nerves, causing muscle contraction to expel foreign objects.

Signup and view all the flashcards

Laryngeal Reflex

The laryngeal reflex protects the trachea by closing the glottis during swallowing, coughing, or stimulation.

Signup and view all the flashcards

Bronchial Anatomy

The right bronchus is wider and shorter than the left. The left bronchus is anterior, while the right bronchus is posterior.

Signup and view all the flashcards

Vallecular Space

The vallecular space is the area where the Macintosh laryngoscope blade is inserted to lift the epiglottis during intubation.

Signup and view all the flashcards

What are autorhythmic cells?

These heart cells have the unique ability to spontaneously generate electrical impulses without external stimulus. They are responsible for setting the heart's rhythm.

Signup and view all the flashcards

What is the SA Node?

The SA Node is the primary pacemaker of the heart, located in the upper right atrium. It generates electrical impulses that trigger the heartbeat.

Signup and view all the flashcards

What is the AV Node?

The AV Node is a group of autorhythmic cells situated near the bottom of the right atrium. It plays a crucial role in delaying the electrical signal before it reaches the ventricles, ensuring proper ventricular contraction.

Signup and view all the flashcards

What is a polarized cardiac cell?

When a cardiac cell is at rest, it has a negative charge, indicating no electrical activity. This state is called 'polarized'.

Signup and view all the flashcards

What is depolarization?

Depolarization is the process where the cardiac cell becomes positively charged due to an influx of sodium ions (Na+) into the cell, triggering an action potential. This is like 'turning on' the cell.

Signup and view all the flashcards

Compensation (blood gas)

The process by which the body attempts to correct an imbalance in blood pH.

Signup and view all the flashcards

Respiratory Compensation

A rapid process of compensation involving the lungs, often seen in conditions like asthma attacks.

Signup and view all the flashcards

Metabolic Compensation

A slower process of compensation involving the kidneys, often seen in conditions like diabetic ketoacidosis.

Signup and view all the flashcards

Base Excess (BE)

A measure of the amount of acid or base needed to bring the blood pH back to normal.

Signup and view all the flashcards

HCO₃⁻ (Bicarbonate)

Abnormal levels of bicarbonate in the blood.

Signup and view all the flashcards

Respiratory Alkalosis

A condition where the blood pH is too high; often caused by a decrease in carbon dioxide (CO₂) levels.

Signup and view all the flashcards

Respiratory Acidosis

A condition where the blood pH is too low; often caused by an increase in carbon dioxide (CO₂) levels.

Signup and view all the flashcards

Metabolic Alkalosis

A condition where the blood pH is too high; often caused by an excess of bicarbonate (HCO₃⁻).

Signup and view all the flashcards

Metabolic Acidosis

A condition where the blood pH is too low; often caused by a deficiency of bicarbonate (HCO₃⁻).

Signup and view all the flashcards

Mixed Acid-Base Disorders

When both respiratory and metabolic components of blood gas analysis show abnormalities.

Signup and view all the flashcards

Study Notes

Burns

  • Skin:
    • Epidermis: 5 layers / Prevents fluid loss
    • Dermis: 2 layers / Body temp regulates
    • Deepest layers → Deest layers take 2-3 weeks
    • Epidermis can't regenerate without dermis

Types of Burns

  • Injury to skin: radiation, radioactivity, electricity, friction or chemicals
  • 1st degree: superficial - no damage to dermis
  • 2nd degree:
    • superficial dermal - fluid, blisters, painful
    • deep dermal - can lead to compartment syndrome if circumferential
  • 3rd degree: full thickness, epidermis + dermis + nerves destroyed - no pain, Black + leathery

Pathophysiology (local response)

  • Zone of coagulation: max damage (clot) - cell death, damage to circulation
  • Zone of stasis: decreased tissue perfusion - tries to pull oxygen in - can become infection, oedema
  • Zone of hyperaemia: blood flow increases due to inflammation (Vascular dilation + increased circulation + histamine)

Systemic Response

  • Release of cytokines + inflammatory mediators once burn reaches 30% tissue areas = capillary permeability.
  • Peripheral + splanchnic vasoconstriction - due to release of catecholamines (body's adrenaline), vasopressin - reduces cardiac contractility - 1HR reduces because of O2 → less vol → less contractility - tries to maintain CO2
  • Together = systemic hypotension + end organ hypoperfusion → Hypovolemic shock/Distributive Shock

Respiratory Changes

  • Stabilize airway +
  • Bronchoconstriction = cytokines released + more resistance + ventilation (decreased) + more O2 + CO2 out - loss of fluids - less oxygen-carrying capacity - decreased perfusion

Metabolic Changes

  • Hypermetabolism → met demand = breakdown of molecules
  • Splanchnic hypoperfusion - needs early aggressive intervention
  • Increased glucose production (glycogenolysis/gluconeogenesis) to generate glucose from non-carbohydrate sources (glycogen).
  • ↓7 leads to decrease in glucose uptake + clearance from the body.
  • Grave crystalloids - mixed evidence of insulin
  • Risk of hypoglycemia

Lethal Triad

  • Loss of volume = loss of O2 = lactic acid = metabolic acidosis
  • Hypothermia - loss of dermis = ↓temp
  • Burns around mouth? smaller tubes?
  • Breathing? Resuscitation via tracheostomy
  • Bronchoscopy: burns to chest?
  • Cardio: Replace the lost fluid vol, IV access, warming, TPV formula + increase O2-carrying capacity, blood pressure, respiratory status.
  • Disability: O2 going to brain, CV compromise - need early intubation
  • treat temp above 42.2°C

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Description

Test your knowledge on crucial concepts in emergency medicine, specifically focusing on major haemorrhage, coagulopathy, and burn injuries. Explore the physiological responses and treatment protocols relevant to critical situations such as significant blood loss and burn management.

More Like This

Major Haemorrhage MCQs
37 questions

Major Haemorrhage MCQs

UnbiasedMossAgate2727 avatar
UnbiasedMossAgate2727
Hypothermia and Major Haemorrhage Quiz
27 questions

Hypothermia and Major Haemorrhage Quiz

FearlessWormhole avatar
FearlessWormhole
Major Haemorrhage Management Quiz
49 questions

Major Haemorrhage Management Quiz

Lauraleexox avatar
Lauraleexox
Use Quizgecko on...
Browser
Open
Browser
Browser