SSM TCAR ACTUAL EXAM 2025 | Trauma
Care after Resuscitation (TCAR) QUESTIONS
AND ANSWERS GRADED A+
What 2 things affect the amount of oxygen availalbe to the cells?
Temperature & pH, which is the oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation shift to the right?
Acidosis, elevated temp
More oxygen available to the cells
Oxyhemoglobin dissociation curve shift to the left?
Hypothermia, alkalosis
Less oxygen available to the cells
H & H is a measure of ?
It is a measure of hemodilution rather than blood loss.
What are the hormonal responses to shock?
Promote body water retentions by secretion of ADH & activation of RAAS
,What are the inflammatory responses to shock?
SIRS
Which is a production of pro-inflammatory mediators, histamine release, and
capillary leakage
Inadvertent esophageal intubation assessment findings include?
Gastric distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration
What is the normal PaCO2 and what does it measure?
Normal 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?
Normal 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?
FIO2 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?
It measures the extent of pulmonary shunting. It quantifies the relationship
between what goes into the lungs and what gets into the blood.
PaO2/FiO2
What is a normal P:F ratio?
Normal is >450,
lower numbers are worse
Patients who are very sensitive to supplemental oxygen are telling us they have
what type of problems?
It is a diffusion problem
What is DO2?
It is oxygen delivery.
It is impacted by manipulating:
SpO2, Hgb, and CO
, What is Vo2?
Oxygen consumption or use. (It is the difference between the oxygen sent (SaO2)
to the cells and the amount that returns to the heart (SvO2) )
Normal VO2 is 180-280
Lactic acid is the marker of what?
Tissue ischemia -anaerobic metabolism
Normal serum lactate is <2
Rib fractures cause a problem where is the cascade?
Ventilation- because it interferes with the mechanical process of breathing
Pulmonary contusion causes a problem where in the cascade?
Diffusion
Bruising and edema impair gas exchange
Best parameter to measure is P:F ration
What is the best parameter to measure diffusion?
P:F ratio
Care after Resuscitation (TCAR) QUESTIONS
AND ANSWERS GRADED A+
What 2 things affect the amount of oxygen availalbe to the cells?
Temperature & pH, which is the oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation shift to the right?
Acidosis, elevated temp
More oxygen available to the cells
Oxyhemoglobin dissociation curve shift to the left?
Hypothermia, alkalosis
Less oxygen available to the cells
H & H is a measure of ?
It is a measure of hemodilution rather than blood loss.
What are the hormonal responses to shock?
Promote body water retentions by secretion of ADH & activation of RAAS
,What are the inflammatory responses to shock?
SIRS
Which is a production of pro-inflammatory mediators, histamine release, and
capillary leakage
Inadvertent esophageal intubation assessment findings include?
Gastric distention,
absent breath sounds,
minimal chest wall movement and
rapid deterioration
What is the normal PaCO2 and what does it measure?
Normal 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?
Normal 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?
FIO2 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?
It measures the extent of pulmonary shunting. It quantifies the relationship
between what goes into the lungs and what gets into the blood.
PaO2/FiO2
What is a normal P:F ratio?
Normal is >450,
lower numbers are worse
Patients who are very sensitive to supplemental oxygen are telling us they have
what type of problems?
It is a diffusion problem
What is DO2?
It is oxygen delivery.
It is impacted by manipulating:
SpO2, Hgb, and CO
, What is Vo2?
Oxygen consumption or use. (It is the difference between the oxygen sent (SaO2)
to the cells and the amount that returns to the heart (SvO2) )
Normal VO2 is 180-280
Lactic acid is the marker of what?
Tissue ischemia -anaerobic metabolism
Normal serum lactate is <2
Rib fractures cause a problem where is the cascade?
Ventilation- because it interferes with the mechanical process of breathing
Pulmonary contusion causes a problem where in the cascade?
Diffusion
Bruising and edema impair gas exchange
Best parameter to measure is P:F ration
What is the best parameter to measure diffusion?
P:F ratio
