Bits and Bobs (mainly stolen from anki) (thanks Joe)
暂无描述。系统推荐的高质量记忆内容，适合每天坚持背诵学习。
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What is the target ICP
<22 mmHg
In bleeding, what endogenous processes have a procoagulant effect
endothelium activation which leads to a) platelet activation and adhesion b) subendothelial tissue is exposed which has procoagulant effects c) clotting factor production and release
In bleeding, what endogenous processes have a anticoagulant effect
a) aPc activation: reduced factor 5 and 8 + increased plasmin b) platelet dysfunction c) glycocalyx barrier is shed d) increased fibrinolysis due to release of tPA, PAP and proteolytic enzymes eg plasmin
What is the definition of ROSC
aortic BP maintained >60 for 10 consecutive minutes
Describe primary, secondary, tertiary and quarternary blast injuries
primary: blast wave itself causing hollow organ damage secondary: debris injuries tertiary: injuries from being thrown from the blast quarternary: injuries as a result of the explosion such as burns
What is the oxygen extraction equation
oxygen extraction = oxygen removed from blood by metabolising tissue/oxygen delivery
as oxygen delivery reduces what happens to oxygen extraction and why
it increases to compensate for the reduced delivery in an attempt to maintain the amount available for tissues to use
what would a high oxygen extraction indicate
reduced delivery increased usage
what would a low oxygen extraction indicate
increased delivery (hyperbaric chamber) decreased usage
what is the downside of permissive hypotension in TBI
further reduces CPP inducing secondary ischaemic injury
Why do we use permissive hypotension
lower hydrostatic pressure so less likely to disturb any clots that have formed reduced acidosis, hypothermia and haemodilution
What prothrombin time indicates ATC and what should be given to correct it
> 18 seconds
What INR indicates haemorrhagic complications
> 1.5
Why do we want to avoid pain in bleeding patients
pain further increases sympathetic activation which in turn leads to: glycocalyx barrier disruption vasoconstriction so worsening tissue hypoxia
What is a downside of ROTEM machines
Don’t take into account any exogenous anticoagulants
State some complications of transfusions
acute haemolytic transfusion reaction (ABO incompatibility) TRALI sepsis TACO
Reference ranges for platelets
140-400 x 10^9/L
Reference ranges for Hb and haematocrit
Hb: 115-180 g/L haematocrit: 0.4-0.54
Normal PT and APTT
PT: 10-14 seconds APTT: 24-37 seconds
Reference ranges for fibrinogen
1.5-4.5 g/L
What is the advantage of being acidotic in bleeding and what are the disadvantages
reduced affinity of Hb for O2 so offloads however… increased work of breathing to compensate reduced catecholamine receptor responsiveness reduced clotting factor activation increased fibrinolysis
TXA complications and contraindications
seizures and hypotension pregnancy, renal failure and seizure history
In which DCS patients should interventional radiology be considered
active arterial pelvic haemorrhage spleen, liver, kidney injury with arterial haemorrhage
define base excess
The amount of acid needed to return 1L of fluid to a normal pH