SSM TCAR REVIEW QUESTIONS AND ANSWERS
What are the definitive options for pelvic fracture stabilization and hemorrhage control? -
Answers :External Fixation
Interventional Radiology
Open reduction & Internal fixation
How many ATP molecules are produced with oxygen & glucose? - Answers :32 ATP
molecules
How many ATP molecules are produced without oxygen? - Answers :2 ATP molecules
Normal pH? - Answers :Refernce range is 7.35-7.45, but actual normal range is 7.38-
7.42
What is the footprint of shock? - Answers :Lactic Acidosis
What 2 things affect the amount of oxygen availalbe to the cells? - Answers
:Temperature & pH, which is the oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation shift to the right? - Answers :Acidosis, elevated temp
More oxygen available to the cells
Oxyhemoglobin dissociation curve shift to the left? - Answers :Hypothermia, alkalosis
Less oxygen available to the cells
H & H is a measure of ? - Answers :It is a measure of hemodilution rather than blood
loss.
What are the hormonal responses to shock? - Answers :Promote body water retentions
by secretion of ADH & activation of RAAS
What are the inflammatory responses to shock? - Answers :SIRS
Which is a production of pro-inflammatory mediators, histamine release, and capillary
leakage
Inadvertent esophageal intubation assessment findings include? - Answers :Gastric
distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration
What is the normal PaCO2 and what does it measure? - Answers :Normal is 35-45
mmHg
It is the measurement of ventilation
Clinical assessment- rate, depth, and work of breathing
,What is the normal PaO2 and what does it measure? - Answers :Normal is 80-100
mmHG
It is a measurement of diffusion
It reflects a problems with alveoli or pulmonary circulation
How do you calculate expected PaO2? - Answers :FIO2 x 5
If it's less than expected for a given FIO2, it is a diffusion problem
How are closed mid-shaft femur fractures managed? - Answers :Intramedullary nail
fixation
What makes a fracture comminuted? - Answers :The bone is in multiple pieces
Physiologic criteria for trauma center care? - Answers :SBP<90
Resp rate <10 or >29
GCS <14
What is Kinematics? - Answers :The process of predicting potential injuries based on
analysis of the forces involved
Dose of energy is? - Answers :The nature and amount of force
Characteristic of wounding agent? - Answers :Type of energy and how it was applied
Force - Answers :The dose of energy involved
Which gender is the majority of trauma? - Answers :Male
Incidence of trauma peaks at what age? - Answers :Teens and young adult
Blunt trauma Classifications include? - Answers :MVA
Auto vs. pedestrian
Falls
Struck by or against an object
Trauma mortality based on organ system failure? - Answers :1 organ system failure=4%
2 organ system failures=32%
3 organ system failures=67%
4 organ system failures=90%
What are the four collisions? - Answers :1. The vehicle
2. The occupants
3. The internal organs
4. The secondary impacts
, Energy transmission in a rollover depends on? - Answers :Deceleration distance
Energy is dissipated over the distance of the roll and whether or not the occupants are
restrained
Car vs pedestrian injuries depend on? - Answers :Point of contact with the care
Height of hood & bumper
Size & weight of vehicle
Height of patient
Direction patient was facing when struck
What is the most common mechanism of injury in all age groups? - Answers :Falls
Factors predicting fall injuries are? - Answers :Fall height (velocity)
Landing surface (deceleration distance)
Point of impact on the body
Wound ballistics- permanent cavity - Answers :Cavity is the a function of the size,
shape, and characteristic of the missile (mass)
For every second of fall time, speed increases by? - Answers :Speed increases by
approximately 20 MPH
Define Shock? - Answers :A state in which cellular oxygen demand exceeds supply
When the cost of tissue oxygen is higher than the body can pay, an oxygen debt
develops.
Types of shock per TCAR? - Answers :Pumps-Site of defect heart
Pipes- site of defect is artery, veins or capillaries
Fluid-intravascular, interstitial or intracellular
VS in shock? - Answers :Narrow pulse pressure
Tachycardia
Low CO
What does of P:F ratio measure and how is it calculated? - Answers :It measures the
extent of pulmonary shunting. It quantifies the relationship between what goes into the
lungs and what gets into the blood.
PaO2/FiO2
What is a normal P:F ratio? - Answers :Normal is >450,
lower numbers are worse
Patients who are very sensitive to supplemental oxygen are telling us they have what
type of problems? - Answers :It is a diffusion problem
What are the definitive options for pelvic fracture stabilization and hemorrhage control? -
Answers :External Fixation
Interventional Radiology
Open reduction & Internal fixation
How many ATP molecules are produced with oxygen & glucose? - Answers :32 ATP
molecules
How many ATP molecules are produced without oxygen? - Answers :2 ATP molecules
Normal pH? - Answers :Refernce range is 7.35-7.45, but actual normal range is 7.38-
7.42
What is the footprint of shock? - Answers :Lactic Acidosis
What 2 things affect the amount of oxygen availalbe to the cells? - Answers
:Temperature & pH, which is the oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation shift to the right? - Answers :Acidosis, elevated temp
More oxygen available to the cells
Oxyhemoglobin dissociation curve shift to the left? - Answers :Hypothermia, alkalosis
Less oxygen available to the cells
H & H is a measure of ? - Answers :It is a measure of hemodilution rather than blood
loss.
What are the hormonal responses to shock? - Answers :Promote body water retentions
by secretion of ADH & activation of RAAS
What are the inflammatory responses to shock? - Answers :SIRS
Which is a production of pro-inflammatory mediators, histamine release, and capillary
leakage
Inadvertent esophageal intubation assessment findings include? - Answers :Gastric
distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration
What is the normal PaCO2 and what does it measure? - Answers :Normal is 35-45
mmHg
It is the measurement of ventilation
Clinical assessment- rate, depth, and work of breathing
,What is the normal PaO2 and what does it measure? - Answers :Normal is 80-100
mmHG
It is a measurement of diffusion
It reflects a problems with alveoli or pulmonary circulation
How do you calculate expected PaO2? - Answers :FIO2 x 5
If it's less than expected for a given FIO2, it is a diffusion problem
How are closed mid-shaft femur fractures managed? - Answers :Intramedullary nail
fixation
What makes a fracture comminuted? - Answers :The bone is in multiple pieces
Physiologic criteria for trauma center care? - Answers :SBP<90
Resp rate <10 or >29
GCS <14
What is Kinematics? - Answers :The process of predicting potential injuries based on
analysis of the forces involved
Dose of energy is? - Answers :The nature and amount of force
Characteristic of wounding agent? - Answers :Type of energy and how it was applied
Force - Answers :The dose of energy involved
Which gender is the majority of trauma? - Answers :Male
Incidence of trauma peaks at what age? - Answers :Teens and young adult
Blunt trauma Classifications include? - Answers :MVA
Auto vs. pedestrian
Falls
Struck by or against an object
Trauma mortality based on organ system failure? - Answers :1 organ system failure=4%
2 organ system failures=32%
3 organ system failures=67%
4 organ system failures=90%
What are the four collisions? - Answers :1. The vehicle
2. The occupants
3. The internal organs
4. The secondary impacts
, Energy transmission in a rollover depends on? - Answers :Deceleration distance
Energy is dissipated over the distance of the roll and whether or not the occupants are
restrained
Car vs pedestrian injuries depend on? - Answers :Point of contact with the care
Height of hood & bumper
Size & weight of vehicle
Height of patient
Direction patient was facing when struck
What is the most common mechanism of injury in all age groups? - Answers :Falls
Factors predicting fall injuries are? - Answers :Fall height (velocity)
Landing surface (deceleration distance)
Point of impact on the body
Wound ballistics- permanent cavity - Answers :Cavity is the a function of the size,
shape, and characteristic of the missile (mass)
For every second of fall time, speed increases by? - Answers :Speed increases by
approximately 20 MPH
Define Shock? - Answers :A state in which cellular oxygen demand exceeds supply
When the cost of tissue oxygen is higher than the body can pay, an oxygen debt
develops.
Types of shock per TCAR? - Answers :Pumps-Site of defect heart
Pipes- site of defect is artery, veins or capillaries
Fluid-intravascular, interstitial or intracellular
VS in shock? - Answers :Narrow pulse pressure
Tachycardia
Low CO
What does of P:F ratio measure and how is it calculated? - Answers :It measures the
extent of pulmonary shunting. It quantifies the relationship between what goes into the
lungs and what gets into the blood.
PaO2/FiO2
What is a normal P:F ratio? - Answers :Normal is >450,
lower numbers are worse
Patients who are very sensitive to supplemental oxygen are telling us they have what
type of problems? - Answers :It is a diffusion problem
