ENARE Practice Questions - ENARE - Exame Nacional De Residências (Brazil) Exam

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A 45-year-old pedestrian is struck by a truck and presents in severe hemorrhagic shock with an unstable pelvic fracture and positive abdominal Focused Assessment with Sonography for Trauma (FAST). Vital signs show BP 68/38 mmHg, HR 148 bpm, cold clammy extremities, and GCS 11 (Class IV hemorrhagic shock). The trauma team initiates a massive transfusion protocol. According to current damage control resuscitation principles, what is the recommended initial resuscitation strategy?

Exclusive infusion of 6 units of packed red blood cells followed by reassessment of hemoglobin before giving plasma. Aggressive infusion of 4 liters of normal saline 0.9% boluses before requesting blood products. Balanced transfusion of packed red blood cells, fresh frozen plasma, and platelets in a 1:1:1 ratio, alongside early administration of intravenous tranexamic acid within 3 hours. High-dose norepinephrine vasopressor infusion to achieve a systolic blood pressure above 140 mmHg.

Correct Answer:

Balanced transfusion of packed red blood cells, fresh frozen plasma, and platelets in a 1:1:1 ratio, alongside early administration of intravenous tranexamic acid within 3 hours.

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