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TCRN EXAM STUDY GUIDE
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TCRN EXAM STUDY GUIDE
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TCRN EXAM STUDY GUIDEShock - 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
Increased risk of coagulopathies
SBIRT - answer- Comprehensive intervention to deliver treatment for substance use
disorders
Screening
Brief Intervention
Referral to Treatment
Triad of Abusive Brain Injury - answer- Subdural Hemorrhage
Retinal Hemorrhage
Decreased LOC
Types of Stress Disorders - answer- State of Crisis - Immediately after event
Acute Stress Disorder - Lasting at least three days
Post Traumatic Stress Disorder - Lasting one month or longer
Three things to identify state of crisis - answer- 1. Perception of the event
2. Support System
3. Coping mechanisms
Steps of Research - answer- 1. Research question
2. Literature Review
3. Research Methodologies
4. Institutional Review Board (IRB)
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