Give her blood! SAQ added anonymously 

 
This SAQ is worth 11 marks

A 55 year old female patient is brought in by ambulance to the emergency department after being involved in a high speed MVA. The pelvic X-ray from her trauma series is reproduced. The c-spine and chest X-rays are normal.

Massive transfusion has been administered while waiting for the retrieval team to provide transfer to the local level 1 trauma centre. An arterial blood gas has been performed.

pH 7.20 (7.35-7.45)
pCO2 30 (35-45)
pO2 58 (50% FiO 2)
HCO3 14 (24-32)
Na+ 140 (135-145)
K+ 6.0 (3.5-5.0)
Cl- 100 (95-110)

View attached:  Attachment 1

Question 1.
Provide two (2) calculations to help you to interpret this gas result. (2 marks)

Derived value 1:

___________________________________________________________________________

Derived value 2:

___________________________________________________________________________



Question 1.
Using this scenario and the derived values, list three (3) potential causes for the abnormal results.
(3 marks)


1. ___________________________________________________________________________

2. ___________________________________________________________________________

3. ___________________________________________________________________________



Question 1.
List six (6) therapeutic goals for resuscitation in the event of massive transfusion. (6 marks)


1. ___________________________________________________________________________

2. ___________________________________________________________________________

3. ___________________________________________________________________________

4. ___________________________________________________________________________

5. ___________________________________________________________________________

6. ___________________________________________________________________________



 
This SAQ is worth 11 marks

A 55 year old female patient is brought in by ambulance to the emergency department after being involved in a high speed MVA. The pelvic X-ray from her trauma series is reproduced. The c-spine and chest X-rays are normal.

Massive transfusion has been administered while waiting for the retrieval team to provide transfer to the local level 1 trauma centre. An arterial blood gas has been performed.

pH 7.20 (7.35-7.45)
pCO2 30 (35-45)
pO2 58 (50% FiO 2)
HCO3 14 (24-32)
Na+ 140 (135-145)
K+ 6.0 (3.5-5.0)
Cl- 100 (95-110)

Question 1.
Provide two (2) calculations to help you to interpret this gas result. (2 marks)

Good answers exhibited:

  • A range of formulae correctly written and accurately worked through
  • Used the information provided to produce DDx e.g. impact of massive transfusion 
  • Showed an understanding of the underlying pathophysiology rather than just list a DDx


Question 1.
Using this scenario and the derived values, list three (3) potential causes for the abnormal results.
(3 marks)



Question 1.
List six (6) therapeutic goals for resuscitation in the event of massive transfusion. (6 marks)




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Comments:

No answers! :-( but LOVING the other questions, so flipping helpful, one of the best resources out there. Thank you.

Suzi Hamilton at 10:27 05 Mar 2016