Trauma 1

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Questions and Answers

What is the most common cause of death in the long term for trauma patients?

  • Hemorrhage
  • Multiorgan failure (correct)
  • Head injury
  • Sepsis

Which organ is commonly injured in blunt trauma, according to the text?

  • Kidney
  • Lung
  • Liver (correct)
  • Spleen

What is the preferred alternative route for intra-osseous cannulation in children under 6?

  • Distal femur
  • Humerus
  • Proximal tibia (correct)
  • Radius

What is the LD50 for falls, according to the text?

<p>4 stories (B)</p> Signup and view all the answers

What is the most common cause of upper airway obstruction, according to the text?

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

What is the initial fluid resuscitation for a patient in hemorrhagic shock?

<p>2 L Lactated Ringers (B)</p> Signup and view all the answers

What is the approximate ratio of RBCs:FFP:platelets in hemostatic resuscitation?

<p>1:1:1 (B)</p> Signup and view all the answers

What is the approximate indication for initiating hemostatic resuscitation?

<p>Receiving ≥ 4 units pRBCs in the first hour (D)</p> Signup and view all the answers

What medication is considered to decrease fibrinolysis and reduce bleeding?

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

What is the recommended approach for patients with acute traumatic coagulopathy?

<p>&quot;Hemostatic resuscitation&quot; to ensure oxygenation and correct coagulopathy (D)</p> Signup and view all the answers

"Damage control surgery" involves which of the following?

<p>&quot;Early control of bleeding and contamination with delay in definitive surgery&quot; (A)</p> Signup and view all the answers

What is an indication for performing a diagnostic peritoneal lavage (DPL)?

<p>Hypotensive patients with blunt trauma (B)</p> Signup and view all the answers

Which injury can be missed by FAST scan (focused abdominal sonography for trauma)?

<p>Retroperitoneal bleed (A)</p> Signup and view all the answers

When should an abdominal CT scan be performed following blunt trauma?

<p>In patients with abdominal pain or need for general anesthesia (C)</p> Signup and view all the answers

What condition warrants exploratory laparotomy?

<p>Uncontrolled visceral hemorrhage in an unstable patient (D)</p> Signup and view all the answers

What kind of injury can be missed by a CT scan following blunt trauma?

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

When should tranexamic acid be administered to a patient?

<p>To decrease fibrinolysis and reduce bleeding (C)</p> Signup and view all the answers

What is the most common cause of death within 30 minutes of trauma, according to the text?

<p>Lacerations of heart (D)</p> Signup and view all the answers

Which organ is stated as the most commonly injured in blunt trauma?

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

What is the preferred site for cutdown for venous access if large bore IV and central access are not possible?

<p>Saphenous vein at ankle (D)</p> Signup and view all the answers

What is the most common cause of upper airway obstruction, according to the text?

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

What is considered the preferred alternative route for intra-osseous cannulation in children under 6?

<p>Proximal tibia (A)</p> Signup and view all the answers

What is the approximate ratio of RBCs:FFP:platelets in hemostatic resuscitation?

<p>1:1:1 (A)</p> Signup and view all the answers

What is an indication for performing a diagnostic peritoneal lavage (DPL)?

<p>Hypotensive patient with blunt trauma (B)</p> Signup and view all the answers

What kind of injury can be missed by a CT scan following blunt trauma?

<p>Diaphragm injury (A)</p> Signup and view all the answers

When should tranexamic acid be administered to a patient?

<p>Decreases fibrinolysis and reduces bleeding (C)</p> Signup and view all the answers

What is the initial fluid resuscitation for a patient in hemorrhagic shock?

<p>2 L Lactated Ringers (D)</p> Signup and view all the answers

"Damage control surgery" involves which of the following?

<p>&quot;Early control of bleeding and contamination with delay in definitive surgery&quot; (D)</p> Signup and view all the answers

What is the most common cause of upper airway obstruction, according to the text?

<p>Foreign body aspiration (A)</p> Signup and view all the answers

When should an abdominal CT scan be performed following blunt trauma?

<p>In patients with abdominal pain or need for general anesthesia (D)</p> Signup and view all the answers

What medication is considered to decrease fibrinolysis and reduce bleeding?

<p>Tranexamic acid (A)</p> Signup and view all the answers

What is the LD50 for falls, according to the text?

<p>Not provided in the text (C)</p> Signup and view all the answers

Which organ is commonly injured in blunt trauma, according to the text?

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

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Study Notes

Trauma Patient Care

  • The most common cause of death in the long term for trauma patients is multi-organ failure.

Blunt Trauma

  • The spleen is commonly injured in blunt trauma.
  • The LD50 for falls is approximately 25-30 ft (7.5-9 meters).

Vascular Access

  • The preferred alternative route for intra-osseous cannulation in children under 6 is the anterior tibia.

Hemorrhagic Shock

  • The initial fluid resuscitation for a patient in hemorrhagic shock is 1-2 liters of crystalloid.

Hemostatic Resuscitation

  • The approximate ratio of RBCs:FFP:platelets in hemostatic resuscitation is 1:1:1.
  • The indication for initiating hemostatic resuscitation is approximately 1-2 blood volumes or 4-6 units of blood products.
  • Tranexamic acid is the medication that decreases fibrinolysis and reduces bleeding.

Damage Control Surgery

  • "Damage control surgery" involves controlling hemorrhage, contaminant elimination, and temporary closure.

Diagnostic Peritoneal Lavage (DPL)

  • An indication for performing a DPL is suspected intra-abdominal injury.

Abdominal Imaging

  • FAST scan (focused abdominal sonography for trauma) can miss hollow viscous injuries.
  • An abdominal CT scan should be performed following blunt trauma when the patient is hemodynamically stable.
  • A CT scan can miss diaphragmatic injuries following blunt trauma.

Upper Airway Obstruction

  • The most common cause of upper airway obstruction is facial trauma.

Fibrinolysis

  • Tranexamic acid should be administered to a patient with evidence of hyperfibrinolysis.

Cutdown

  • The preferred site for cutdown for venous access if large bore IV and central access are not possible is the groin.

Note: LD50 stands for Lethal Dose 50%, which is the dose required to kill 50% of the test subjects. In this case, it represents the height from which a fall would be fatal for 50% of individuals.

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