Emergency Medicine: Blood Loss and Burns Quiz

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?

Transfusion-associated circulatory overload (TACO). Signup and view all the answers

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

Control of bleeding and blood volume replacement. Signup and view all the answers

Which of the following is true regarding FFP and cryoprecipitate?

FFP contains all clotting factors including fibrinogen. Signup and view all the answers

What characterizes a 3rd degree burn?

Full thickness with nerve destruction and no pain Signup and view all the answers

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

Zone of coagulation Signup and view all the answers

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

Release of catecholamines and decreased blood flow to regions Signup and view all the answers

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

Loss of volume leading to lactic acid buildup Signup and view all the answers

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

Mechanical ventilation may stabilize the airway Signup and view all the answers

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

Respiratory compensation Signup and view all the answers

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

Alkalosis Signup and view all the answers

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

Metabolic issue Signup and view all the answers

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

-2/+2 Signup and view all the answers

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

Move in opposite directions Signup and view all the answers

Which of the following indicates compensatory metabolic acidosis?

A low HCO₃⁻ level with high CO₂ Signup and view all the answers

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

Hyperventilation Signup and view all the answers

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

At risk of condition deteriorating, requiring acute ward support Signup and view all the answers

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

PaCO₂ levels Signup and view all the answers

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

Standardized airway management devices Signup and view all the answers

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

Increased CO₂ + H₂O production Signup and view all the answers

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

Needs additional observation or intervention, possibly from ICU Signup and view all the answers

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

Communicate effectively with ICU personnel Signup and view all the answers

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

Changes in CO₂ and HCO₃⁻ move in opposite directions Signup and view all the answers

What does SBAR stand for in the context of handover?

Situation, Background, Assessment, Recommendation Signup and view all the answers

Which statement is true regarding Level 3 critical care patients?

They usually have complex multi-organ failure and need advanced support. 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?

Standardized PPE for safety Signup and view all the answers

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

Assist in monitoring and managing the patient’s condition. Signup and view all the answers

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

Risk of acidosis Signup and view all the answers

Which statement accurately describes the pharyngeal reflex?

It protects against aspiration by causing muscle contraction. Signup and view all the answers

What is the primary function of the laryngeal reflex?

Prevents foreign objects from entering the trachea Signup and view all the answers

How does general anesthesia (GA) affect airway reflexes?

It suppresses brain activity inhibiting reflexes. Signup and view all the answers

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

Wider and shorter Signup and view all the answers

What does the acronym BURP represent in airway management?

Backwards Upwards Rightward Pressure Signup and view all the answers

Which structure serves to surround and support the vocal cords?

Arytenoid cartilage Signup and view all the answers

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

Blocks sensory messages Signup and view all the answers

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

Protects vocal cords and facilitates sound Signup and view all the answers

What role does the vallecular space play in airway management?

It is where the mac blade is used to lift the epiglottis. Signup and view all the answers

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

Serves as the main pacemaker Signup and view all the answers

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

Depolarization (Phase 0) Signup and view all the answers

What is indicated by the PR interval in cardiac rhythm?

Delay in the AV node Signup and view all the answers

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

K+ channels close and K+ leaves the cell Signup and view all the answers

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

Polarized state with a negative resting membrane potential Signup and view all the answers

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

Immunoglobulin E (IgE) Signup and view all the answers

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

Coughing Signup and view all the answers

What mechanism causes bronchoconstriction during an anaphylactic reaction?

Histamine binding to smooth muscle receptors Signup and view all the answers

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

Cardiovascular shock Signup and view all the answers

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

Intramuscular adrenaline (epinephrine) Signup and view all the answers

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.

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.