Which fluids need to be administered in the trauma patient? when? In trauma patients, fluid resuscitation aims at restoring circulating volume to prevent cardiac arrest due to severe hypovolemia, and at achieving a satisfying level of mean arterial pressure to ensure adequate tissue perfusion, limiting coagulation disorders. Lot of potential secondary adverse effects could be associated to fluid resuscitation, ie hemodilution, acidosis & coagulation disorders.
In this infographic, the concepts of permissive hypotension and remote damage control resuscitation RDCR, and some notes on on crystalloids, colloids & blood products.
graphics by Marta Velia Antonini @FOAMecmo
content based on the talk given by Sophie Hamada, ICU Hôpital Bicêtre University Paris Sud, Groupe Traumabase.EU during the Trauma & surgery session of the EDIC I Refresher Course at #LIVES2019 Congress
Pitfalls in the trauma case management:
thoraco-abdominal penetrating injuries
pelvic circumferential fractures
posterior dislocation of the hip
Be careful to avoid common cognitive errors, premature diagnosis, over-reliance upon early negative results, attributing abnormal findings to benign causes, early grading injury severity based on signs in young healthy adults, distractions due to focus on main/obvious injuries and on performing a critical procedure. Also consider lot of potential communications error, lack of situational awareness & errors in staffing or workload distribution.
PS do not forget analgesia & sedation!
infographic based on the talk given by Sharon Einav, Shaare Zedek Medical Center, Hebrew University Faculty of Medicine, Jerusalem, Israel during the Trauma & surgery session of the EDIC I Refresher Course at LIVES2019
graphics by M Velia Antonini @FOAMecmo