Trauma Nurse Core Course (TNCC) Practice Exam

Why is serum lactate measured in the initial assessment of a trauma patient?

1. To measure oxygenation and ventilation

2. To quantify the base deficit for the adequacy of cellular perfusion

3. To gauge end-organ perfusion and tissue hypoxia

4. To determine the underlying cause of shock

The correct answer is: To gauge end-organ perfusion and tissue hypoxia

Measuring serum lactate in the initial assessment of a trauma patient is critical for gauging end-organ perfusion and tissue hypoxia. Elevated levels of lactate can indicate that tissues are not receiving sufficient oxygen, which can occur due to inadequate blood flow or shock. When there is insufficient oxygen supply, cells switch from aerobic metabolism to anaerobic metabolism, leading to the production of lactate as a byproduct. Therefore, high lactate levels can serve as a marker for the severity of tissue hypoxia and the effectiveness of the body's perfusion. This assessment is particularly important in trauma situations, where rapid identification of compromised perfusion can influence treatment decisions and improve patient outcomes. Monitoring lactate levels can help healthcare providers determine the severity of the patient's condition and the need for interventions such as fluid resuscitation or more aggressive supportive measures. While other aspects such as oxygenation, base deficit, and underlying causes of shock are important, the primary role of measuring serum lactate in this context lies in its strong correlation with tissue perfusion and hypoxia.