Cen : Shock And Multisystem Trauma

Front 1

Cardiovascular reserve and ability to compensate for blood loss is limited in older adults, especially if the pt is on

Back 1

Beta Blockers

Front 2

Trauma definition

Back 2

Injury to the body caused by acute exposure to mechanical, thermal, electrical, or chemical energy

Front 3

Kinetic Energy formula

Back 3

Mass xVelocity^2 / 2

Consider - doubling the size of the object doubles the kinetic energy, while doubling the speed quadruples the kinetic energy

Front 4

Waddells Triad

Back 4

is a pattern of injury seen in pedestrian children who are struck by motor vehicles. The triad comprises:

* fractured femoral shaft
* intra-thoracic or intra-abdominal injuries
* contralateral head injury

mechanism of injury is an initial impact causing injury to the femur on one side (bumper injury) and the torso on the same side (fender or hood), following which the child is thrown, striking the head on the ground or another object and sustaining injury to the opposite side of the head

Front 5

Low Velocity bullets travel at ____ fps

Medium Velocity bullets travel at ____fps

High Velocity bullets travel at ___fps

Back 5

Low Velocity bullets travel at 1000 fps

Medium Velocity bullets travel at 2000 fps

High Velocity bullets travel at 3000 fps

Front 6

Hypothermia results in the following (pg719)

Back 6

1) Shifts in oxyhemoglobin dissociation curve, which impairs tissue oxygen delivery

2) Shivering, which increases oxygen consumption

3) Impaired platelet function causes coagulopathy

4) Increased blood viscosity

5) Myocardial depression

6) Acidosis

Front 7

Afterdrop(in hypothermia)(pg721)

Back 7

decrease of core body temperature that occurs with redistribution of cold blood returning from peripheral tissues

Front 8

Hypovolemic Shock caused by...

Back 8

inadequate intravascular volume

Front 9

Cardiogenic Shock caused by...

Back 9

impaired ability of the heart to pump blood effectively

Front 10

Distributive Shock(including septic, anaphylactic, neurogenic) caused by...

Back 10

massive vasodilation and a resultant relative hypovolemia

Front 11

Septic Shock(1/3 types of Distributive) caused by...

Back 11

massive vasodilation caused by mediators of the inflammatory process in response to overwhelming infection

Front 12

Anaphylactic Shock(1/3 types of Distributive) caused by...

Back 12

massive vasodilation caused by release of histamine in response to severe allergic reaction

Front 13

Neurogenic Shock(1/3 types of distributive) caused by...

Back 13

massive vasodilation caused by suppression of sympathetic nervous system

Front 14

Myocardial Depression occurs when MAP <_____, causing myocardial ischemia

Back 14

Myocardial Depression occurs when MAP <60, causing myocardial ischemia

Front 15

Metabolic acidosis occurs since _____ is produced as a byproduct of _____ metabolism and accumulates in the blood. (pg724)

Back 15

Metabolic acidosis occurs since lactic acid is produced as a byproduct of anaerobic metabolism and accumulates in the blood.

Front 16

Loss of autoregulation and brain ischemia occur when cerebral perfusion pressure is <_____ mm Hg (pg724)

Back 16

Loss of autoregulation and brain ischemia occur when cerebral perfusion pressure is <50 mm Hg

Front 17

Compensatory stage of shock BP changes(pg725)

Back 17

Systolic stays the same while diastolic increases, resulting in a decreased pulse pressure

DBP is a reflection of arterial elasticity. The vasoconstriction caused by the SNS causes an elevation in DBP.

Front 18

In Shock hyperglycemia is related to ____ and ____ ____ and occurs in patients without a dx of diabetes. Goal is serum glucose <____mg/dl (pg 730)

Back 18

In Shock hyperglycemia is related to stress and insulin resistance and occurs in patients without a dx of diabetes. Goal is serum glucose <150mg/dl

Front 19

Class I Hemorrhagic Shock

Back 19

<15%, <750ml

Pulse pressure = widened or normal

Slightly anxious

Front 20

Class II Hemorrhagic Shock

Back 20

15-30%, 750-1500ml

HR >100

Pulse pressure = narrowed

Ventilatory rate = 20-30

Skin = cool, pale

Front 21

Class III Hemorrhagic Shock

Back 21

30-40%, 1500-2000

HR>120

BP decreased

Pulse pressure = narrowed

Ventilatory rate = 30-40

Skin = cool,moist pale

Anxious, confused

Front 22

Class IV Hemorrhagic Shock(pg 732)

Back 22

>40%, >2000ml

HR <140

BP decreased

Pulse Pressure narrowed

Ventilatory rate = >35

Skin = cold, clammy, cyanotic

Confused, lethargy

Front 23

Bacteremia (definition)(pg738)

Back 23

presence of viable bacteria in the blood

Front 24

Sepsis (definition (pg738)

Back 24

systemic state generalized by the presence of invading microorganisms and their toxins in blood and tissues; SIRS associated with infection

Front 25

Severe Sepsis(definition) (pg738)

Back 25

sepsis associated with organ dysfunction, hypoperfusion, or hypotension

Front 26

Septic Shock (definition) (pg738)

Back 26

shock resulting from massive vasodilation caused by release of mediators of the inflammatory process in overwhelming infection.

Sepsis with hypotension despite adequate fluid resuscitation along with presence of perfusion abnormalities.

Front 27

Severe Sepsis clinical presentation (pg738+740)

Back 27

HR >90bpm

Hyperthermia (>38c) or Hypothermia (<36c)

RR >20 or Paco2 <32

WBC >12,000 or <4000 or >10% bands

evidence of at least one organ dysfunction(ie AMS, or oliguria with increased creatinine)