TCRN QUESTIONS WITH 100% CORRECT SOLUTIONS 2023/2024

TCRN QUESTIONS WITH 100% CORRECT SOLUTIONS 2023/2024 List three effects of inflammatory mediators - CORRECT ANSWER Diaphoresis, glycogeonolysis, bronchodilation, increased: HR, contractility, automasticity, RR Describe the technique for inserting IO into distal femur - CORRECT ANSWER Anterior midline above the external epicondyles, 1 - 3cm above the femoral plateau; the knee slightly flexed and the hip externally rotated and flexed Describe the technique for inserting IO into distal tibia - CORRECT ANSWER just proximal to the medial malleolus Describe the technique for inserting IO into humerus - CORRECT ANSWER Directly above the greater tuberosity Describe the technique for inserting IO into proximal tibia - CORRECT ANSWER 2cm distal and slightly medial to the tibial tuberosity Recognize adequate fluid resuscitation using four end points to resuscitation - CORRECT ANSWER Traditional - Vital signs, urinary output (>0.5mg/kg/hr), Mental status Invasive hemodynamic monitoring - Central Venous Pressure (normal 2-6mmHg), Pulmonary wedge pressure (8-10mmHg), Cardiac Index (2.5 - 4.0L/minute/m^2), Delivery of oxygen (DO2) (500-600mL O2/min/m^2) Metabolic parameters - Lactate (>4 is severe), Base Deficit (>6mmol/L indicates severe injury) Treatment for neurogenic shock - CORRECT ANSWER 1 -2 L bolus (often insufficient and may cause pulmonary edema) Vasopressors (Epi, Norepi, dopamine, phenylephrine, or vasopressin) MAP 85-90mmHg Atropine respiratory support as needed List 6 effects that a state of crisis may have on a trauma patient - CORRECT ANSWER Disruption of family Depression Failure to return to pre-event life Economic problems Social isolation Decreased pleasure in activities PTSD Treatment goals for patients with PTSD - CORRECT ANSWER Restore sense of control Diminish power of the traumatic event Reduce chronic hyperarousal Reduce feelings of guilt/self-blame Restore sense of equilibrium List three patient dispositions allowed by COBA/EMTALA legislation - CORRECT ANSWER Admission to the facility Stabilizing care, followed by transfer to qualified facility Treated and discharged What is the performance improvement loop? - CORRECT ANSWER Identify the outcomes Determine plan Measure progress