Orthonotes
Orthonotes
by the.bonestories
v3.0 Fusion
v3.0 Fusion
trauma topic hub

Shock and Resuscitation in Orthopaedics

Types: hypovolemic (hemorrhagic), distributive (septic, neurogenic), cardiogenic, obstructive. Initial approach: ATLS (Airway with C‑spine, Breathing, Circulation, Disability, Exposure). Hemorrhagic shock is most common in trauma; control bleeding + balanced transfusion (1:1:1) + permissive hypotension until hemorrhage control (except TBI). Resuscitation targets: lactate clearance, base deficit, urine output, MAP appropriate to context. Adjuncts: TXA within 3 hours of injury; damage control surgery principles. Orthopaedic hemorrhage control: pelvic binder, traction for femoral shaft, external fixation, tourniquet in limb exsanguination. Endpoints: normalization of mentation, MAP, lactate/base deficit clearance, warm peripheries, adequate urine output.

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Types: hypovolemic (hemorrhagic), distributive (septic, neurogenic), cardiogenic, obstructive. Initial approach: ATLS (Airway with C‑spine, Breathing, Circulation, Disability, Exposure). Hemorrhagic shock is most common in trauma; control bleeding + balanced transfusion (1:1:1) + permissive hypotension until hemorrhage control (except TBI). Resuscitation targets: lactate clearance, base deficit, urine output, MAP appropriate to context. Adjuncts: TXA within 3 hours of injury; damage control surgery principles. Orthopaedic hemorrhage control: pelvic binder, traction for femoral shaft, external fixation, tourniquet in limb exsanguination. Endpoints: normalization of mentation, MAP, lactate/base deficit clearance, warm peripheries, adequate urine output.
MCQs

High-yield practice questions

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Question 1

What is the most common type of shock encountered in orthopaedic trauma patients?

Question 2

According to ATLS guidelines, which of the following is NOT a primary step in the initial approach to a trauma patient?

Question 3

What is the recommended blood product transfusion ratio in the management of traumatic hemorrhagic shock?

Question 4

In the context of traumatic hemorrhagic shock, what is the principle of permissive hypotension?

Question 5

Which adjunct therapy is recommended to reduce mortality in patients with traumatic hemorrhagic shock if administered within 3 hours of injury?

Question 6

Which of the following conditions is classified as obstructive shock?

Question 7

What is the estimated blood loss for a femoral shaft fracture?

Question 8

Which clinical sign is most indicative of hypovolemic shock?

Question 9

What is the target urine output during resuscitation in trauma patients?

Question 10

In the management of pelvic fractures, which method is commonly employed to control hemorrhage?