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31 Cards in this Set
- Front
- Back
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Which fluid therapy is this?
- the most commonly used fluid in trauma resuscitation - compatible with blood product transfusion and most medications - Na: 154mEq/L - Cl: 154mEq/L |
Normal Saline
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Which fluid therapy is this?
- Na: 130mEq/L - CL: 109mEq/L - K: 4mEq/L - HCO3: 28mEq/L - Ca: 2.7mEq/L - can stimulate immune system - not compatible with blood product transfusions and with some medications |
Lactate Ringer
- help resolve acidosis in trauma/burn patients - may exacerbate acidosis in severely underperfused patients |
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Which fluid therapy is this?
- Na: 77mEq/L - CL: 97mEq/L - K: 20mEq/L - Dextrose: 50 - mildly hypotonic |
D5 1/5NS +20KCL
- often used as replacement fluid |
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What is 3% NaCl fluid therapy used for?
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- resuscitation fluid in burns, traumatic brain injury, intracranial HTN
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What is Plasmanate fluid used for?
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Plasmanate: dilute colloid of 5% albumin in saline.
- occasionally used in anesthesia |
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What is Hespan (hetastarch) fluid used in?
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Hetastarch: synthetic colloid
- use limited in trauma - excellent volume expanders - can interfere with coagulation |
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What are Dextran 40 and 70 fluid used in?
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Dextran 40 and 70: synthetic colloid
- volume expander - hemorheologic modifiers - used in vascular situations |
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One unit of transfused blood equates to a patient Hgb rise of ____ g/dL
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One unit of transfused blood equates to a patient Hgb rise of 1 g/dL
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Fresh frozen plasma (FFP) is rich in _____.
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Fresh frozen plasma (FFP) is rich in fibrinogen, coagulation factors, and protein.
- amount determined by clinical appearance and PT |
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Cryoprecipitate is rich in _____.
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Cryoprecipitate is rich in fibrinogen.
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Indications for mechanical ventilatory support.
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- respiratory rate >35/min
- vital capacity <15mL/Kg - (A-a)DO2 >350kPa after 15min on 100% O2 - Vd/Vt > 0.6 - PaO2 < 60kPa - PaCO2 > 60kPa |
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What to do next?
- incompatible blood transfusion |
1. stop transfusion
2. foley catheter 3. alkaline urine with 45 meq sodium bicarbonate (alkaline environment inhibit hemoglobin precipitation in renal tubules) 4. diuresis with 100ml of 20% mannitol |
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Physiologic alteration in ARDS.
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1. hypoxemia unresponsive to elevations of inspired O2 concentration
2. decreased pulmonary compliance (stiffer) 3. decreased functional residual capacity |
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List factors that shift the O2 saturation curve to the right.
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- 2.3 DPG
- acidosis - chronic lung disease |
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What causes the most frequent infectious complication from blood transfusion?
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HepC
- may cause cirrhosis, hepatoma |
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What to do next?
- post operative choleccystitis confirmed with US |
percutaneous drainage of the gallbladder
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List some cardiac risk factors in noncardiac surgical patients.
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- previous infarction within 6 month
- dyspnea on exertion - age over 70 - mitral regurgitation - >5 PVCs |
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Local anesthetics:
name some regions of the body that you should not use epinephrine containing lidocaine for analgesia. |
tissues supplied by end arteries
- fingers, toes - ears - nose - penis |
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Composition of cryoprecipitate.
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- factor VIII
- von willebrand factor - fibrinogen - factor XIII |
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What conditions can be treated with FFP?
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- coumadin over treatment
- massive blood loss - antithrombin III deficiency - humoral immune deficiencies - TTP |
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What conditions can be treated with cryoprecipitate?
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- hemophilia
- von willebrands disease - hypofinbrinogenemia (with massive transfusions) |
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What is the diagnosis and what to do next?
In OR after administer inhalational anesthetics and succinylcholine: - fever - tachycardic - increased O2 consumption, CO2 production - hyperkalemia - myoglobinuria - acidosis |
malignant hyperthermia
- hyperventilation of 100% O2 - IV dantroleme - alkalinize urine to protect the kidneys |
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Side effects of this anesthetic drug:
- nitrous oxide |
- bowel obstruction
- intestinal distention - pneumothorax |
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Side effects of this anesthetic drug:
- halothane |
hypotension
decreased CO |
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Side effects of this anesthetic drug:
- enflurane |
seizures
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Side effects of this anesthetic drug:
- methoflurane |
least volitile
- nephrotoxicity |
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Side effects of this anesthetic drug:
- morphine |
- hypotension
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What is the renal dose of Dopamine?
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Low dose
- mainly works on D1 receptor - vasodilation of renal and mesenteric vasculature |
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Which receptors does the median dose of Dopamine work on?
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beta1 receptor (increase CO, BP)
- used in shock, CHF) |
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Which receptors does the pressor (high) dose of Dopamine work on?
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alpha receptors
- cause peripheral vasoconstriction |
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What is the cause of post op cholecystitis?
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gall bladder ischemia
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