TCCC CLS EDUCATOR PREPARATION DIGITAL LEARNING MODULE ASSESSMENT ITEMS ANSWER KEY 2026 GRADED A+

TCCC CLS EDUCATOR PREPARATION
DIGITAL LEARNING MODULE ASSESSMENT
ITEMS ANSWER KEY 2026 GRADED A+

⩥ Why do you administer PO fluids if the casualty is not in shock and
can swallow? (TFC #2)
Answer: - helps treat/prevent dehydration
- oral fluids are OK even if the casualty is wounded in the abdomen
(aspiration is rare, low risk in the light of the benefit, dehydration
increases mortality)


⩥ What is the order of precedence for fluid resuscitation of casualties in
hemorrhagic shock? (TFC #2)
Answer: - whole blood
- 1:1:1 plasma:RBCs:platelets
- 1:1 plasma:RBCs
either plasma (liquid, thawed, dried) or RBCs alone
- Hextend
- Lactated Ringer's or Plasma-Lyte A


⩥ What are the goals of fluid resuscitation therapy? (TFC #2)
Answer: - improved state of consciousness (if no TBI)

,- palpable radial pulse corresponds roughly to systolic blood pressure of
80 mmHg
- avoid over-resuscitation of shock from torso wounds
- too much fluid volume may make internal hemorrhage worse by
"Popping the Clot"


⩥ Why would you NOT try to restore a normal blood pressure? (TFC
#2)
Answer: blood pressure goes up...


if it goes up too much, it may interfere with your body's attempt to clot
off an internal bleeding site by diluting clotting factors and increasing
the pressure to the point where the clot is disrupted by the hydrostatic
force exerted by the IV fluid


⩥ Why do you use Hextend instead of the much less expensive Ringer's
Lactate used in civilian trauma? (TFC #2)
Answer: 1000ml of Ringer's Lactate (2.4 pounds) will yield an
expansion of the circulating blood volume of only about 200ml one hour
after the fluid is given


- the other 800 ml of RL has left the circulation after an hour and entered
other fluid spaces in the body (fluid that has left the circulation does not
help treat shock and may cause other problems)

,⩥ What does Hextend do? (TFC #2)
Answer: - less weight to carry for equal effect
- stays where it is supposed to be longer and does the casualty more
good
- less likely to cause undesirable side effects


⩥ How many ml of hetastarch do you use for resuscitation fluid? (TFC
#2)
Answer: 500ml of 6% hetastarch (trade name Hextend, weighs 1.3lbs)
will yield an expansion of the intravascular volume of 600-800ml


intravascular expansion is still present 8 hours later


⩥ What are the Crystalloid Fluid Shifts? (TFC #2)
Answer: small sodium, chloride, potassium, etc. from crystalloids leak
through the vessel membranes


⩥ What happens to crystalloid fluid shifts? (TFC #2)
Answer: - in 1 hour, 25% of crystalloid fluid is still in the vascular space
- for a 1000ml bag, that's only 250ml still in the vessels
- the rest diffuses to the interstitial and intracellular space


⩥ What are the Hextend Fluid Shifts? (TFC #2)

, Answer: - large Hextend particles remain in the vessels for 8 hours
- osmotic pressure pulls additional water from the interstitial and
intracellular spaces into the vessels
- the expansion resulting from 500ml of Hextend is 500 to 650ml of
blood volume


⩥ How much water does the average adult human body contain? (TFC
#2)
Answer: 42L of water


- 2/3 of that water is inside the cells (28L)
- 1/3 of that water is inside the blood vessels and in the "interstitial
space" (14L)


⩥ If we have an average of 5L inside blood vessels, how many liters are
within the interstitial space? (TFC #2)
Answer: 9 liters


⩥ What is the maximum dose of Hextend? (TFC #2)
Answer: 1,000ml (1,600ml of volume expansion effect)


⩥ To get the same effect of Hextend from crystalloid, how many ml of
Hextend does it require?
Answer: 7,000ml per casualty