TCRN EXAM
Shock - Answer -Lack of oxygen to the cells
Hypovolemic Shock - Answer -Lack of volume
ex: hemorrhage, burns
Distributive Shock - Answer -Maldistribution of blood (pooled in extremities)
Decreased preload
ex: neurogenic shock
Cardiogenic Shock - Answer -Inadequate cardiac output
ex: blunt cardiac trauma
Obstructive Shock - Answer -Inability of blood to enter or exit heart properly
ex: tamponade, tension pneumothorax
Systemic Inflammatory Response Syndrome (SIRS) - Answer -Severe tissue trauma activates an
inflammatory response leading to vasodilation, capillary permeability, and coagulation
,Early (Compensated) Shock - Answer -Normal BP
Weak, thready pulse
Deep and rapid RR
Normal lactic levels
Anxious
Late (Decompensated) Shock - Answer -Decreased BP
Tachycardia
Shallow and rapid RR
Increased Lactic
Decreased LOC
Decreased urinary output
BUN to Creatinine Ratio - Answer -Normal - 10:1
Indicated effective renal function
Trauma Triad of Death - Answer -Hypothermia
Acidosis
Coagulopathies
Effects of Acidosis - Answer -Increased ICP
Exacerbates coagulopathies
Depressed myocardial contractility
DIC - Answer -Excessive clotting > all clotting factors used > no more clotting > excessive bleeding
Effects of coagulopathies - Answer -Decreased platelet count
Decreased fibrinogen
Decreased HnH
,Increased PT, PTT
Increased Ddimer
Multi-Organ Dysfunction Syndrome (MODS) - Answer -Irreversible Shock resulting from Triad of Death
Symptoms start within the first week after trauma
Steps to control hemorrhage - Answer -Tourniquet
TXA
REBOA
Permissive Hypotension
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) - Answer -Occlusion of the Aorta
below the diaphragm to reduce bleeding
Type A - Answer -RBC: Type A, O
Plasma: Type A, AB
Type B - Answer -RBC: Type B, O
Plasma: Type B, AB
Type AB - Answer -RBC: Type A, B, AB, O
Plasma: AB
Type O - Answer -RBC: Type O
Plasma: Type A, B, AB, O
Universal Donor of RBC and Plasma - Answer -Universal donor of RBC: O negative
Universal donor of Plasma: AB negative
, Cryoprecipitate - Answer -Concentrate of coagulation factors obtained from fresh frozen plasma
Increases fibrinogen in the bloodstream
Blood Transfusion in Peds - Answer -One unit of blood is 10ml/kg
Complications of MTP - Answer -Hypothermia - warm all fluids and blood
Hypocalcemia - replace calcium
Acidosis - sodium bicarb
TRALI - stop transfusion, supplemental oxygen
Transfusion-Related Acute Lung Injury (TRALI) - Answer -Pulmonary edema due to rapid blood
administration
MTP Protocol - Answer -1 : 1 : 1
RBC : Plasma : Platelet
Blood Loss Grades - Answer -I - Loss of 15% with normal BP
II - Loss of 15-30% with normal BP
III - Loss: of 31-40% with lowered BP
IV - Loss > 40% with hemodynamic instability
Permissive Hypotension - Answer -Maintaining BP as low as 70/40 so allow for clotting.
Contra-indicated in head injuries, peds, and elderly
SCIWORA - Answer -Spinal Cord Injury WithOut Radiological Abnormality
Common in Age < 2 yrs
Significance of Bariatric Patients - Answer -Increased HR and RR at baseline
Increased abdominal pressures
Shock - Answer -Lack of oxygen to the cells
Hypovolemic Shock - Answer -Lack of volume
ex: hemorrhage, burns
Distributive Shock - Answer -Maldistribution of blood (pooled in extremities)
Decreased preload
ex: neurogenic shock
Cardiogenic Shock - Answer -Inadequate cardiac output
ex: blunt cardiac trauma
Obstructive Shock - Answer -Inability of blood to enter or exit heart properly
ex: tamponade, tension pneumothorax
Systemic Inflammatory Response Syndrome (SIRS) - Answer -Severe tissue trauma activates an
inflammatory response leading to vasodilation, capillary permeability, and coagulation
,Early (Compensated) Shock - Answer -Normal BP
Weak, thready pulse
Deep and rapid RR
Normal lactic levels
Anxious
Late (Decompensated) Shock - Answer -Decreased BP
Tachycardia
Shallow and rapid RR
Increased Lactic
Decreased LOC
Decreased urinary output
BUN to Creatinine Ratio - Answer -Normal - 10:1
Indicated effective renal function
Trauma Triad of Death - Answer -Hypothermia
Acidosis
Coagulopathies
Effects of Acidosis - Answer -Increased ICP
Exacerbates coagulopathies
Depressed myocardial contractility
DIC - Answer -Excessive clotting > all clotting factors used > no more clotting > excessive bleeding
Effects of coagulopathies - Answer -Decreased platelet count
Decreased fibrinogen
Decreased HnH
,Increased PT, PTT
Increased Ddimer
Multi-Organ Dysfunction Syndrome (MODS) - Answer -Irreversible Shock resulting from Triad of Death
Symptoms start within the first week after trauma
Steps to control hemorrhage - Answer -Tourniquet
TXA
REBOA
Permissive Hypotension
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) - Answer -Occlusion of the Aorta
below the diaphragm to reduce bleeding
Type A - Answer -RBC: Type A, O
Plasma: Type A, AB
Type B - Answer -RBC: Type B, O
Plasma: Type B, AB
Type AB - Answer -RBC: Type A, B, AB, O
Plasma: AB
Type O - Answer -RBC: Type O
Plasma: Type A, B, AB, O
Universal Donor of RBC and Plasma - Answer -Universal donor of RBC: O negative
Universal donor of Plasma: AB negative
, Cryoprecipitate - Answer -Concentrate of coagulation factors obtained from fresh frozen plasma
Increases fibrinogen in the bloodstream
Blood Transfusion in Peds - Answer -One unit of blood is 10ml/kg
Complications of MTP - Answer -Hypothermia - warm all fluids and blood
Hypocalcemia - replace calcium
Acidosis - sodium bicarb
TRALI - stop transfusion, supplemental oxygen
Transfusion-Related Acute Lung Injury (TRALI) - Answer -Pulmonary edema due to rapid blood
administration
MTP Protocol - Answer -1 : 1 : 1
RBC : Plasma : Platelet
Blood Loss Grades - Answer -I - Loss of 15% with normal BP
II - Loss of 15-30% with normal BP
III - Loss: of 31-40% with lowered BP
IV - Loss > 40% with hemodynamic instability
Permissive Hypotension - Answer -Maintaining BP as low as 70/40 so allow for clotting.
Contra-indicated in head injuries, peds, and elderly
SCIWORA - Answer -Spinal Cord Injury WithOut Radiological Abnormality
Common in Age < 2 yrs
Significance of Bariatric Patients - Answer -Increased HR and RR at baseline
Increased abdominal pressures
