RDCR

Question 1

What is damage control resuscitation?

Answer 1

Life saving interventions only

Question 2

When do we use damage control resuscitation?

Answer 2

1. Severe bleeding (shock)
2. Severe multiple trauma
3. Suvivable brain injury 4.Contamination (bowel, debris)

Question 3

What are the components of damage control resuscitation?

Answer 3

1. Permissive hypotension
2. Whole blood
3. TXA
4. Avoid acidosis/hypothermia
5. Stop the bleeding
6. Stop contamination

Question 4

What is the benefit from permissive hypotension?

Answer 4

We limit the risk of rebleeding

Question 5

What should you constantly monitor during permissive hypotension?

Answer 5

1. LOC
2. Respiration rate
3. Radial, femoral or carotid pulse
4. Heart rate
5. Blood pressure
6. Lactate
7. (Diuresis)

Question 6

What is an acceptable BP for a casualty in shock who can be evacuated to definitive care within short time

Answer 6

Around 80 systolic

Question 7

What is the preferred BP for a casualty in shock whom you attend to for a longer period before evacuation?

Answer 7

100-110 systolic

Question 8

What does the citrate in the blood products do?

Answer 8

Binds calcium causing hypocalcemia

Question 9

What blood product is most effective in providing coagulation factors?

Answer 9

Whole blood

Question 10

What is a normal lactate level for a healthy person at rest?

Answer 10

Around 2mmol/ml

Question 11

Name some bad things about clear fluid and resuscitation?

Answer 11

1. No O2 carrying capacity
2. Only 30% stays in vessels
3. Causes damage to endothelium and therefor occupies coagulationfactors
4. Dilutes coagulation factors

Question 12

What do we need blood for?

Answer 12

1. Carry O2 (RBC)
2. Immune response (WBC)
3. Clotting (Platelets + clotting factors)
4. pH buffer
5. Hormones transport
6. Nutrients transport
7. Water
8. Proteins

Question 13

What is the biggest player in oxygendelivery?

Answer 13

Cardiac output
DO2=1,34 x Hgb x SaO2 x CO

Question 14

What is primary hemostasis?

Answer 14

1. Activation of platelets
2. Vasoconstriction

Question 15

What is secondary homeostasis?

Answer 15

1. Activation of coagulation factors cascade (calcium is needed in every step)

Question 16

What are the benefits of stored whole blood?

Answer 16

1. No leucocytes
2. Screened for diseases
3. Low titer

Question 17

What is the definition of shock?

Answer 17

Hypoperfusion in the tissue

Question 18

Which persons should you generally avoid using as blood donors?

Answer 18

1. Pregnant women
2. Dehydrated persons
3. Persons <60kg

Question 19

What is the relation between volume of 1-1-1 blood components and 1 bag whole blood?

Answer 19

Whole blood is around 450ml
Blood components are almost 1100 ml

Question 20

What are the best tactical indicators for shock?

Answer 20

1. Decreased LOC
2. Weak/abcent radial pulse
3. Mechanism of injury

Question 21

What is the 1. BP of choice?

Answer 21

LTOWB

Question 22

What do you do if a patient you are transfusing develops anaphylaxis?

Answer 22

1. Stop the infusion
2. Adrenaline 0,5mg IM to latteral thigh
3. IV-Fluid bolos as needed
4. Follow ABC’s (Give corticosteroid and antihistamine)