2017 Trauma University: Trauma Resuscitation and Beyond-Trauma Resuscitation and Beyond

Trauma Resuscitation and Beyond - handout

Pdf Summary

This document discusses trauma resuscitation and the effects of fluid administration on patient outcomes. The typical scenario described involves a 24-year-old male who is intoxicated and involved in a motor vehicle accident. The patient arrives at the trauma bay undressed, hypotensive, and with positive findings on a focused assessment with sonography for trauma (FAST). The patient is taken to the operating room for treatment, where blood products are administered and coagulopathy is addressed.<br /><br />The importance of coagulopathy is highlighted, and the effects of fluid administration including hypothermia, acidosis, and disruption of blood clotting are discussed. The document also provides a historical perspective on fluid resuscitation, including the work of Sydney Ringer who studied the effects of different saline solutions on the heart.<br /><br />The document presents data on the relationship between coagulopathy and mortality, as well as the impact of controlled resuscitation on patient outcomes. It discusses the use of different fluid resuscitation techniques and their effectiveness in trauma patients. The study by Bickell et al. is referenced, which investigates the effects of delayed fluid resuscitation on hypotensive patients with penetrating torso injuries.<br /><br />The document also discusses the use of plasma in trauma resuscitation and its benefits in addition to its effects on coagulation. Different forms of plasma administration are discussed, including thawed fresh frozen plasma (FFP), liquid plasma, and dried plasma. The potential benefits of plasma administration are presented, including its ability to inhibit vascular endothelial permeability and protect the endothelial glycocalyx.<br /><br />Other topics covered in the document include new advancements in trauma resuscitation such as the use of the Junctional Emergency Treatment Tool, the Abdominal Aortic Tourniquet, and the Xstat and Arsenal Foam technologies for managing severe bleeding.<br /><br />In summary, this document provides an overview of trauma resuscitation and the importance of fluid administration in improving patient outcomes. It highlights the challenges and potential solutions in managing coagulopathy and discusses new advancements in trauma resuscitation techniques.

Keywords

trauma resuscitation

fluid administration

patient outcomes

coagulopathy

hypothermia

acidosis

blood clotting

fluid resuscitation techniques

plasma administration

advancements in trauma resuscitation