Multisystem Trauma and Shock Flashcards

What is the recommended ratio of packed red blood cells, plasma, and platelets in a massive transfusion protocol?

Answer: 1:1:1

A balanced 1:1:1 ratio of PRBCs, FFP, and platelets best mimics whole blood and reduces coagulopathy.

Which component of the 'lethal triad' of trauma worsens as a result of large-volume crystalloid resuscitation?

Answer: Hypothermia and coagulopathy

The lethal triad is hypothermia, acidosis, and coagulopathy, all aggravated by excessive crystalloid.

A trauma patient receiving massive transfusion develops perioral tingling and a prolonged QT interval. What electrolyte abnormality is most likely?

Answer: Hypocalcemia

Citrate in stored blood binds calcium, causing hypocalcemia with QT prolongation and perioral tingling.

Which assessment finding most strongly suggests an obstructive cause of shock rather than hypovolemia?

Answer: Distended neck veins

Distended neck veins suggest obstructive shock (tamponade or tension pneumothorax), whereas hypovolemia produces flat neck veins.

What is the primary goal of damage control surgery in the unstable polytrauma patient?

Answer: Control hemorrhage and contamination

Damage control surgery prioritizes rapid hemorrhage and contamination control over definitive repair to avoid the lethal triad.

Tranexamic acid (TXA) is most beneficial when administered to a trauma patient within what timeframe?

Answer: Within 3 hours of injury

TXA reduces mortality when given within 3 hours of injury and may increase harm if given later.

Which sign indicates that fluid resuscitation has restored adequate end-organ perfusion?

Answer: Urine output of 0.5 mL/kg/hr or more

Urine output of at least 0.5 mL/kg/hr indicates adequate renal perfusion and effective resuscitation.