Page 292 - Critical Care Nursing Demystified

Chapter 6 CARE OF THE TRAUMATIZED PATIENT 277

TABLE 6–4 Complications of Massive Blood Transfusions (Continued)
Complication Cause Signs/Symptoms Treatment
5. Hypothermia Blood is kept stored Chills and shakes Blood
in a refrigerator and Core temperature warmer to
when rapidly infused drops infuse blood
changes core
temperature
6. Oxygen delivery Stored blood binds Change in the level Monitor the
changes more strongly with of responsiveness; O level of
2
hemoglobin tachycardia, the ABGs
tachypnea, and Administer
lower SaO higher FiO
2 2
7. Thrombocy- Platelets do not Drop in thrombo- Administer
topenia store well in blood cytes platelets
Stop bleed-
ing by
pressure

Care of the Patient With Specific Traumatic Injuries According to Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
the ABCs of Trauma Assessment

Airway

Maxillofacial Injuries (MFIs)

What Went Wrong?
8 MFIs are caused from blunt or penetrating objects that meet the cranium
with force. Many MFIs are benign and heal without surgical intervention. Since
the airway can be compromised all MFIs must be suspected of causing airway
obstruction, breathing issues because the upper airway is a conduit for gases to
the lungs, or circulatory problems because this area is very vascular. These can
be life threatening if not detected early.
The face is largely unprotected, with soft tissues as well as bony structures
that can be injured in traumatic incidents. MFIs often coincide with head and
cervical spinal cord injuries. Obvious deformities may exist with maxillofacial
injuries and can cause airway obstruction and death if airway and breathing
mechanisms are not immediately and adequately established. Soft tissue swell-
ing can obstruct the airway and occlude breathing. Because of the nature of the
injuries, the patient may also be unable to see, smell, taste, or even speak. Nasal
bones, the zygoma and mandibular condyle, are most susceptible to fracture.