Lecture 14 highlights

Question 1

What approach is used for evaluation & treatment in surgical critical care?

Answer 1

Organ system eval

Question 2

What are the ARDS criteria? (important)

Answer 2

Acute onset, hypoxemia, non-cardiogenic pulmonary edema, & bilateral pulmonary infiltrates on CXR.

Question 3

___________ is most common cause of AKI in SICU

Answer 3

Hypovolemia

Question 4

Name a rare form of vasogenic shock

Answer 4

Shock due to adrenal insufficiency
(random cortisol <15)

Question 5

What is there a risk of with surgical wounds?

Answer 5

Rhabdo

Question 6

Which neck zone has the highest mortality rate regarding penetrating injuries?

Answer 6

Zone 1

Question 7

Thoracic injuries: What are the indications for thoracotomy in each setting? (important)

Answer 7

Question 8

1) Most commonly injured organ in blunt injury is what?
2) What is a common surgical procedure for this? (although surgery usually not needed)

Answer 8

1) Liver
2) Laparotomy

Question 9

Descr the 2 main courses of Tx for splenic injuries

Answer 9

1) Grades I-III without active bleeding = managed with bed rest, serial abdominal exams, close VS monitoring, & serial Hgb
2) Grades IV & V + active bleeding = angioembolization considered

Question 10

Extremity injuries:
1) What do all pts req?
2) What do signs of vascular injury req?

Answer 10

1) Vascular exam
2) Signs of vascular injury (“hard signs”) require angiogram or operative exploration:

Question 11

What is the lethal triad? [during exsanguinating hemorrhage]

Answer 11

coagulopathy, hypothermia, & metabolic acidosi

Question 12

T/F: Indications for operative intervention in pregnant pts do not differ from non-pregnant trauma patients

Answer 12

True

Question 13

What are not used to treat burn wounds prophylactically?

Answer 13

Systemic antibiotics

Question 14

1) Surgical excision of burn wound should occur within _______ hrs
2) __________ is the 1st choice for wound coverage

Answer 14

1) 72hrs
2) Autologous skin

Question 15

1) Desired urine output for adults?
2) What abt for kids?

Answer 15

1) 0.5-1.0 mL/kg/h
2) 1.0-1.5 mL/kg/h

Question 16

What is the parkland formula?

Answer 16

Total fluid needed = 4 mL LR x body weight (kg) x % TBSA burned