The two subcategories of C in marche?
-cooling prevention & litter placement
-circulation
What does BIFT stand for in Circulation?
B: bleeding control
I: IV/IO
F: Fluid Resus
T: Tq assess/convert/remove
CT-6 indications? Contraindications?
Indications: -midshaft femur fracture -can be used as splint without traction also
Contraindications:
-lack of time
-pelvic fracture
-femoral neck/hip fracture
-distal femoral fracture
-adjacent knee fracture
-fracture/amputated foot/ankle
IO indications? Contraindications?
Indications: -need give fluid and cant do IV
Contraindications:
-bone fractured
-infection at site
-excessive tissue
-osteoporosis
-orthopedic site
-IO attempted in last 48hours
What are the IO sites?
Proximal Tibial (the only one for peds)
Distal Tibial
Proximal Humerus
Sternum
Not in notes, for nerds:
What is in Ringers Lactate? What is the pH?
NaCl, Nalactate, KCl, CaCl, H2O
6.5 pH (slightly acidic but within human range-lactate will be liver processed into bicarbonate which is alkaline)
What is the lethal diamond?
Coagulopathy
Hypocalcemia
Acidosis
Hypothermia
What is the order of tx for 3.3 Hemorrhagic Shock for an adult?
Aggressive Hemorrhage Control
Basic Airway/Resp Management
Cooling Prevention/Litter Placement
IV/IO
TXA if Cpl
Rapid Evac DCR(damage control Resus) including blood
RL/NS 250bolus until radial/bp90(consider TBI)
Hypothermia Management
Urinary Catheter in Prolonged Evac
How much fluid to bolus in hem shock protocol?
250 to max 1L until bp90+ or radial
What are the indications and contraindications to Tq removal?
Indications: attempt to do within 2 hours
Contraindications:
-complete amp
-hemorrhagic shock
->4 hours
-cant monitor for rebleed
-bleeding can nit be controlled otherwise
Indications for TQ assessment/conversion/removal? Contraindications?
-TQ applied in CUF on clothing
-Can be controlled by other means
-replace to Pneumatic Tq
Contraindications: >4hours
What are the 2 types of IO kits?
FAST 1: sternum
TALON:
Both can be left for up to 24hours. Can be inserted through burns.
Ensure to flush with 10mL saline.
Insert at 90’ to bone surface. Humerus 45’.
With Talon, confirm 5mm line before advancing catheter.
