Critical Care & Stabilization Flashcards

Using the Parkland formula, how much fluid should a 70 kg adult with 30% TBSA burns receive in the first 8 hours?

Answer: 4,200 mL

4 mL × 70 kg × 30% equals 8,400 mL over 24 hours, and half (4,200 mL) is given in the first 8 hours from the time of injury.

What is the appropriate prehospital treatment for an open (sucking) chest wound?

Answer: Vented chest seal or three-sided occlusive dressing

A vented or three-sided dressing lets air escape and prevents a tension pneumothorax from developing.

Which initial chest tube output suggests a massive hemothorax that may need operative thoracotomy?

Answer: 1,500 mL or more of immediate blood output

An immediate return of 1,500 mL or more, or continued output above 200 mL/h for 2–4 hours, is a typical trigger for thoracotomy.

A patient with a cervical spinal cord injury stays hypotensive after appropriate fluid resuscitation, and hemorrhage has been ruled out. What is the next step?

Answer: Vasopressor support such as norepinephrine

Neurogenic shock is a problem of lost vascular tone, so vasopressors are needed once volume has been replaced.

What is the main purpose of the FAST exam in an unstable trauma patient?

Answer: Detecting free fluid in the pericardium and peritoneum

FAST quickly finds hemoperitoneum or pericardial fluid at the bedside to guide decisions about surgery.

After a prolonged crush entrapment is released, which ECG finding suggests a dangerous electrolyte shift?

Answer: Peaked T waves

Reperfusion releases potassium from damaged muscle, and hyperkalemia appears first as peaked T waves.

In a ventilated patient with severe TBI and no signs of herniation, what PaCO2 range is generally targeted?

Answer: 35–45 mmHg

Normocapnia is maintained routinely, and brief hyperventilation is reserved for signs of herniation because low CO2 causes cerebral vasoconstriction and ischemia.