The VIP approach for treating the unstable Patient: ventilate (oxygen!) – infuse (fluids!) – pump (drugs?) à VIP helps you to put together and never forget these very simple elements
SOSD for fluid administration – in which phase are we? : S (salvage) the unstable patient – give fluids; O (optimization) e.g., passive leg raising to further assess need for fluids; S (stabilization); D (de-escalation) e.g., diuretics?
- rational thinking – vs. survival approach “flight or fight”
- key distinctions for decision making: structures (SOP) can help but staff must be trained for it
- global thinking (guidelines) vs. local conditions (SOPs)
- Don’t mix up guidelines (based on evidence, significant clinical impact but not mandatory) and SOPs (mandatory)
by Julia Wagner