List three effects of inflammatory mediators - Answer -Diaphoresis, glycogeonolysis, bronchodilation,
increased: HR, contractility, automasticity, RR
Describe the technique for inserting IO into distal femur - Answer -Anterior midline above the external
epicondyles, 1 - 3cm above the femoral plateau; the knee slightly flexed and the hip externally rotated
and flexed
Describe the technique for inserting IO into distal tibia - Answer -just proximal to the medial malleolus
Describe the technique for inserting IO into humerus - Answer -Directly above the greater tuberosity
Describe the technique for inserting IO into proximal tibia - Answer -2cm distal and slightly medial to the
tibial tuberosity
Recognize adequate fluid resuscitation using four end points to resuscitation - Answer -Traditional - Vital
signs, urinary output (>0.5mg/kg/hr), Mental status
Invasive hemodynamic monitoring - Central Venous Pressure (normal 2-6mmHg), Pulmonary wedge
pressure (8-10mmHg), Cardiac Index (2.5 - 4.0L/minute/m^2), Delivery of oxygen (DO2) (500-600mL
O2/min/m^2)
, Metabolic parameters - Lactate (>4 is severe), Base Deficit (>6mmol/L indicates severe injury)
Treatment for neurogenic shock - Answer -1 -2 L bolus (often insufficient and may cause pulmonary
edema)
Vasopressors (Epi, Norepi, dopamine, phenylephrine, or vasopressin)
MAP 85-90mmHg
Atropine
respiratory support as needed
List 6 effects that a state of crisis may have on a trauma patient - Answer -Disruption of family
Depression
Failure to return to pre-event life
Economic problems
Social isolation
Decreased pleasure in activities
PTSD
Treatment goals for patients with PTSD - Answer -Restore sense of control
Diminish power of the traumatic event
Reduce chronic hyperarousal
Reduce feelings of guilt/self-blame
Restore sense of equilibrium
List three patient dispositions allowed by COBA/EMTALA legislation - Answer -Admission to the facility
Stabilizing care, followed by transfer to qualified facility
Treated and discharged
What is the performance improvement loop? - Answer -Identify the outcomes
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