Multisystem Trauma and Shock Flashcards

Which finding suggests that a trauma patient is progressing from compensated to decompensated shock?

Answer: Narrowing pulse pressure with falling blood pressure

A narrowing pulse pressure followed by falling blood pressure signals failing compensation and decompensated shock.

A patient with a high thoracic spinal cord injury is at risk for autonomic dysreflexia. Which trigger is most common?

Answer: Bladder distention

Bladder distention is the most common noxious stimulus triggering autonomic dysreflexia in high spinal cord injury.

Which vasopressor is typically first-line for distributive (septic) shock unresponsive to fluids?

Answer: Norepinephrine

Norepinephrine is the first-line vasopressor for septic shock due to its potent vasoconstriction with modest inotropy.

A trauma patient develops bilateral diffuse infiltrates, refractory hypoxemia, and a PaO2/FiO2 ratio of 150. Which condition is most likely?

Answer: Acute respiratory distress syndrome

ARDS is defined by acute bilateral infiltrates and a PaO2/FiO2 ratio below 300 without cardiac cause.

What is the recommended ventilation strategy for a trauma patient with ARDS?

Answer: Low tidal volume 6 mL/kg of predicted body weight

Low tidal volume (6 mL/kg PBW) lung-protective ventilation reduces ventilator-induced injury in ARDS.

Which assessment is the priority during the primary survey of a multisystem trauma patient?

Answer: Airway with cervical spine protection

The ABCDE primary survey begins with airway and cervical spine protection as the first priority.

A trauma patient on massive transfusion develops oozing from IV sites and mucous membranes. Which condition should be suspected?

Answer: Disseminated intravascular coagulation

Diffuse bleeding from multiple sites during major trauma suggests disseminated intravascular coagulation (DIC).