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32 Cards in this Set
- Front
- Back
What ICP is abnormal?
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>20mmHg
>40 is severe sustained increased ICP leads to decreased brain function and poor outcome |
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CBF is maintained at a mean BP of what?
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50-150
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what is the Monro-Kellie Doctrine of head injury?
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total volume of the intracranial compartment must stay constant
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Lucid interval, bi convex (lenticular) skull fracture that may be rapidly fatal... what is the classic artery affected?
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middle meningeal
this is an Epidural |
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what vessel is responsible for a brain bleed that crosses suture lines and is concave...
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Bridging veins (brain laceration)
subdural hematoma |
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When is rapid surgical evacuation of a subdural recommended?
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>5mm shift of midline
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loss of gray/white matter differentiation indicates what
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diffuse axonal damage
this has poor outcomes |
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give a Mild, Moderate, or severe GCS (the ranges)
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Mild 15-13
Moderate 12-9 Severe < 8 |
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if patient has a GCS of 12 or below, when should you get a repeat CT?
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6 hours
or if they have notable deterioration |
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Indications for CT a pt with head injury?
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GCS still <15 two hours after injury
Neuro deficit open skull fracture sign of basal skull fracture vomiting >2 episodes extremes of age retrograde amnesia |
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pt is conscious, cooperative, able to concentrate on C-spine
no neck/spine tenderness if still no pain or tenderness with voluntary movement what should you do? |
no further evaluation or xray needed
can clear the c-spine and remove collar |
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if a pt has altered LOC or has sx, what should be obtained?
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CT
radiographic visualization of entire spine |
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what 3 views do you need for c-spine xray
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Cross table lateral
AP Odontoid (open mouth) |
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if you find an isolated c-spine fracture, what should you look for?
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ANOTHER noncontiguous vertebral column fracture
it happens 10% of the time |
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what % of pts with spinal cord injuries will worsen at the hospital
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5%
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Dorsal column carries what info? same side or opposite side?
*** |
position, vibration, fine touch
ipsilateral side |
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two fracture sites that are commonly missed sites that can cause shock? How much blood can go there?
(*?*) |
5L in pelvis
1.5L in femur |
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how soon after arrival should a patient with major open MSCK wounds be given abx?
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within the first hour
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when getting xrays, what must you get a picture of in in addition to the site of injury
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joint above and below
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2 most common places for compartment syndrome
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tibia and forearm
can be caused by severe crush injury, burn, casts tissue pressures >35-40 mm Hg |
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Myoglobinuria can result from what kind of injury? What should you do?
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Crush injury
hydrate |
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know that the cervical spine in old people has lots of OA....
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so it makes them tough to intubate
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most common cause of death/disability in kids?
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injury
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3 ways kids are harder to intubate
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smaller jaw
larger tongue anterior larynx |
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if a child is laying on a backboard, what must you consider
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put a pad under the back...
the large head of the child will cause them to be in flexion if on a back board. Having the pad will neutralize the c-spine |
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kids less than 10, seen at C2/3, seen worse in felxion...
what xray finding does this describe? |
pseduosubluxation
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what is the 442 rule?
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for Maintenance fluid
4mL/kg for first 10 kg 2mL/kg for second 10kg 1mL/kg for every kg beyond 20 kg |
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ETT depth is how long in kids?
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3x the ETT size
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bolus for kids?
blood dosage? |
fluid: 20 mL/kg
blood: 10 mL/kg |
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What is the Parkland formula
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2-4/mL x weight in kg x % body surface area
first half over the first 8 hours second half over the next 16 used in burns |
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are the following increased or decreased in pregnancy?
minute ventilation HR/CO Blood Volume GFR gastric emptying time |
all increased
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are the following increased or decreased in pregnancy?
pCO2 Hematocrit |
Decreased
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