Anaes Vivas · Plastics and burns anaesthesia
Burn excision and grafting: blood loss, temperature, massive transfusion — viva
Structured oral examination station for burn-excision-massive-transfusion.
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ANZCAFRCAEDAICABAFCAI
Prompt
Theatre temperature 18°C; patient core 34.5°C; Hb 68; active excision ongoing.
Opening
State the one-line answer first: blood in theatre, warmers on, balanced products with calcium, TXA within 3 hours, no suxamethonium, stage when physiology fails.[5][1][4][8]
References10ShowHide
- [1]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet, 2010.PMID 20554319
- [2]Baxter CR Fluid volume and electrolyte changes of the early postburn period. Clin Plast Surg, 1974.PMID 4609676
- [3]Martyn JA, Richtsfeld M Succinylcholine-induced hyperkalemia in acquired pathologic states: etiologic factors and molecular mechanisms. Anesthesiology, 2006.PMID 16394702
- [4]Roberts I, Shakur H, Afolabi A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet, 2011.PMID 21439633
- [5]Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA, 2015.PMID 25647203
- [6]Moore EE, Moore HB, Kornblith LZ, et al. Trauma-induced coagulopathy. Nat Rev Dis Primers, 2021.PMID 33927200
- [7]Giancarelli A, Birrer KL, Alban RF, et al. Hypocalcemia in trauma patients receiving massive transfusion. J Surg Res, 2016.PMID 27083965
- [8]Gronert GA, Theye RA Pathophysiology of hyperkalemia induced by succinylcholine. Anesthesiology, 1975.PMID 1147311
- [9]Yentis SM Suxamethonium and hyperkalaemia. Anaesth Intensive Care, 1990.PMID 2186663
- [10]Li G, Cheng L, Wang J Comparison of Rocuronium with Succinylcholine for Rapid Sequence Induction Intubation in the Emergency Department: A Retrospective Study at a Single Center in China. Med Sci Monit, 2021.PMID 33441534