Complex Trauma Case Study-Handout - Complex Trauma Case Study

Handout - Complex Trauma Case Study

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This document is a complex trauma case study presented by Dr. Charles Mains. The case involves a 35-year-old female who was involved in a high-speed car accident, resulting in significant injuries. The patient presented with neck pain, abdominal tenderness, and a large seat belt sign. At the scene, she received oxygen and IV fluids, and her airway was managed with a mask. The question was posed about the appropriate airway management in this scenario.<br /><br />The document also discussed the importance of timely hemorrhage control in trauma patients and the various strategies to achieve this. It emphasized the need for quick compression of compressible hemorrhage, the use of tourniquets or pressure to control non-compressible hemorrhage, and the role of pelvic binders. The concept of permissive hypotension and limiting crystalloid administration was also discussed.<br /><br />Next, the document addressed the use of tranexamic acid (TXA) in trauma patients with coagulopathy. The dosing and mechanism of action of TXA were explained, along with the results of the CRASH-2 trial and the MATTERS trial, which showed a reduction in mortality with the use of TXA.<br /><br />The case study then discussed the appropriate management of a patient with grade 4 blunt cerebrovascular injury (BCVI) and solid organ injuries. The options for treatment, including antiplatelet therapy, anticoagulation, and endovascular interventions, were presented.<br /><br />The document also highlighted the importance of damage control resuscitation (DCR) in trauma patients when hemorrhage control cannot be achieved rapidly. The goals of DCR were outlined, including primary hemorrhage control, contamination control, prevention of abdominal compartment syndrome, and leaving the abdomen open for further resuscitation.<br /><br />Overall, the case study emphasized the need for a systematic and multidisciplinary approach to trauma care, considering various factors such as airway management, hemorrhage control, fluid resuscitation, medication administration, and appropriate surgical interventions.

Keywords

complex trauma case study

Dr. Charles Mains

high-speed car accident

neck pain

abdominal tenderness

seat belt sign

airway management

hemorrhage control

tranexamic acid (TXA)

blunt cerebrovascular injury (BCVI)