SSM TCAR REVIEW EXAM
QUESTIONS WITH COMPLETE
SOLUTIONS
What are the definitive options for pelvic fracture stabilization and hemorrhage control? -
ANSWERSExternal Fixation
Interventional Radiology
Open reduction & Internal fixation
How are closed mid-shaft femur fractures managed? - ANSWERSIntramedullary nail
fixation
What makes a fracture comminuted? - ANSWERSThe bone is in multiple pieces
Physiologic criteria for trauma center care? - ANSWERSSBP<90
Resp rate <10 or >29
GCS <14
What is Kinematics? - ANSWERSThe process of predicting potential injuries based on
analysis of the forces involved
Dose of energy is? - ANSWERSThe nature and amount of force
Characteristic of wounding agent? - ANSWERSType of energy and how it was applied
Force - ANSWERSThe dose of energy involved
Which gender is the majority of trauma? - ANSWERSMale
Incidence of trauma peaks at what age? - ANSWERSTeens and young adult
Blunt trauma Classifications include? - ANSWERSMVA
Auto vs. pedestrian
Falls
Struck by or against an object
Trauma mortality based on organ system failure? - ANSWERS1 organ system
failure=4%
2 organ system failures=32%
3 organ system failures=67%
4 organ system failures=90%
,What are the four collisions? - ANSWERS1. The vehicle
2. The occupants
3. The internal organs
4. The secondary impacts
Energy transmission in a rollover depends on? - ANSWERSDeceleration distance
Energy is dissipated over the distance of the roll and whether or not the occupants are
restrained
Car vs pedestrian injuries depend on? - ANSWERSPoint of contact with the care
Height of hood & bumper
Size & weight of vehicle
Height of patient
Direction patient was facing when struck
What is the most common mechanism of injury in all age groups? - ANSWERSFalls
Factors predicting fall injuries are? - ANSWERSFall height (velocity)
Landing surface (deceleration distance)
Point of impact on the body
Wound ballistics- permanent cavity - ANSWERSCavity is the a function of the size,
shape, and characteristic of the missile (mass)
For every second of fall time, speed increases by? - ANSWERSSpeed increases by
approximately 20 MPH
Define Shock? - ANSWERSA state in which cellular oxygen demand exceeds supply
When the cost of tissue oxygen is higher than the body can pay, an oxygen debt
develops.
Types of shock per TCAR? - ANSWERSPumps-Site of defect heart
Pipes- site of defect is artery, veins or capillaries
Fluid-intravascular, interstitial or intracellular
VS in shock? - ANSWERSNarrow pulse pressure
Tachycardia
Low CO
How many ATP molecules are produced with oxygen & glucose? - ANSWERS32 ATP
molecules
How many ATP molecules are produced without oxygen? - ANSWERS2 ATP molecules
Normal pH? - ANSWERSRefernce range is 7.35-7.45, but actual normal range is 7.38-
7.42
, What is the footprint of shock? - ANSWERSLactic Acidosis
What 2 things affect the amount of oxygen availalbe to the cells? -
ANSWERSTemperature & pH, which is the oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation shift to the right? - ANSWERSAcidosis, elevated temp
More oxygen available to the cells
Oxyhemoglobin dissociation curve shift to the left? - ANSWERSHypothermia, alkalosis
Less oxygen available to the cells
H & H is a measure of ? - ANSWERSIt is a measure of hemodilution rather than blood
loss.
What are the hormonal responses to shock? - ANSWERSPromote body water
retentions by secretion of ADH & activation of RAAS
What are the inflammatory responses to shock? - ANSWERSSIRS
Which is a production of pro-inflammatory mediators, histamine release, and capillary
leakage
Inadvertent esophageal intubation assessment findings include? - ANSWERSGastric
distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration
What is the normal PaCO2 and what does it measure? - ANSWERSNormal is 35-45
mmHg
It is the measurement of ventilation
Clinical assessment- rate, depth, and work of breathing
What is the normal PaO2 and what does it measure? - ANSWERSNormal is 80-100
mmHG
It is a measurement of diffusion
It reflects a problems with alveoli or pulmonary circulation
How do you calculate expected PaO2? - ANSWERSFIO2 x 5
If it's less than expected for a given FIO2, it is a diffusion problem
What does of P:F ratio measure and how is it calculated? - ANSWERSIt measures the
extent of pulmonary shunting. It quantifies the relationship between what goes into the
lungs and what gets into the blood.
PaO2/FiO2
QUESTIONS WITH COMPLETE
SOLUTIONS
What are the definitive options for pelvic fracture stabilization and hemorrhage control? -
ANSWERSExternal Fixation
Interventional Radiology
Open reduction & Internal fixation
How are closed mid-shaft femur fractures managed? - ANSWERSIntramedullary nail
fixation
What makes a fracture comminuted? - ANSWERSThe bone is in multiple pieces
Physiologic criteria for trauma center care? - ANSWERSSBP<90
Resp rate <10 or >29
GCS <14
What is Kinematics? - ANSWERSThe process of predicting potential injuries based on
analysis of the forces involved
Dose of energy is? - ANSWERSThe nature and amount of force
Characteristic of wounding agent? - ANSWERSType of energy and how it was applied
Force - ANSWERSThe dose of energy involved
Which gender is the majority of trauma? - ANSWERSMale
Incidence of trauma peaks at what age? - ANSWERSTeens and young adult
Blunt trauma Classifications include? - ANSWERSMVA
Auto vs. pedestrian
Falls
Struck by or against an object
Trauma mortality based on organ system failure? - ANSWERS1 organ system
failure=4%
2 organ system failures=32%
3 organ system failures=67%
4 organ system failures=90%
,What are the four collisions? - ANSWERS1. The vehicle
2. The occupants
3. The internal organs
4. The secondary impacts
Energy transmission in a rollover depends on? - ANSWERSDeceleration distance
Energy is dissipated over the distance of the roll and whether or not the occupants are
restrained
Car vs pedestrian injuries depend on? - ANSWERSPoint of contact with the care
Height of hood & bumper
Size & weight of vehicle
Height of patient
Direction patient was facing when struck
What is the most common mechanism of injury in all age groups? - ANSWERSFalls
Factors predicting fall injuries are? - ANSWERSFall height (velocity)
Landing surface (deceleration distance)
Point of impact on the body
Wound ballistics- permanent cavity - ANSWERSCavity is the a function of the size,
shape, and characteristic of the missile (mass)
For every second of fall time, speed increases by? - ANSWERSSpeed increases by
approximately 20 MPH
Define Shock? - ANSWERSA state in which cellular oxygen demand exceeds supply
When the cost of tissue oxygen is higher than the body can pay, an oxygen debt
develops.
Types of shock per TCAR? - ANSWERSPumps-Site of defect heart
Pipes- site of defect is artery, veins or capillaries
Fluid-intravascular, interstitial or intracellular
VS in shock? - ANSWERSNarrow pulse pressure
Tachycardia
Low CO
How many ATP molecules are produced with oxygen & glucose? - ANSWERS32 ATP
molecules
How many ATP molecules are produced without oxygen? - ANSWERS2 ATP molecules
Normal pH? - ANSWERSRefernce range is 7.35-7.45, but actual normal range is 7.38-
7.42
, What is the footprint of shock? - ANSWERSLactic Acidosis
What 2 things affect the amount of oxygen availalbe to the cells? -
ANSWERSTemperature & pH, which is the oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation shift to the right? - ANSWERSAcidosis, elevated temp
More oxygen available to the cells
Oxyhemoglobin dissociation curve shift to the left? - ANSWERSHypothermia, alkalosis
Less oxygen available to the cells
H & H is a measure of ? - ANSWERSIt is a measure of hemodilution rather than blood
loss.
What are the hormonal responses to shock? - ANSWERSPromote body water
retentions by secretion of ADH & activation of RAAS
What are the inflammatory responses to shock? - ANSWERSSIRS
Which is a production of pro-inflammatory mediators, histamine release, and capillary
leakage
Inadvertent esophageal intubation assessment findings include? - ANSWERSGastric
distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration
What is the normal PaCO2 and what does it measure? - ANSWERSNormal is 35-45
mmHg
It is the measurement of ventilation
Clinical assessment- rate, depth, and work of breathing
What is the normal PaO2 and what does it measure? - ANSWERSNormal is 80-100
mmHG
It is a measurement of diffusion
It reflects a problems with alveoli or pulmonary circulation
How do you calculate expected PaO2? - ANSWERSFIO2 x 5
If it's less than expected for a given FIO2, it is a diffusion problem
What does of P:F ratio measure and how is it calculated? - ANSWERSIt measures the
extent of pulmonary shunting. It quantifies the relationship between what goes into the
lungs and what gets into the blood.
PaO2/FiO2
