Trauma ICU Rounds Episode 4 - Endpoints of Resuscitation
Apr 7, 2020
Dr. Matt Martin, a trauma acute care surgeon from Scripps Mercy Hospital, dives into the intricacies of resuscitating critically injured patients. He discusses the vital assessment of 'sick' versus 'not sick' patients and the advantages of early whole blood transfusions. The conversation highlights the importance of monitoring lactate and base deficit in predicting outcomes, as well as the emerging methods in blood pressure management for traumatic brain injuries. Additionally, Matt emphasizes the innovative use of non-invasive technologies to enhance trauma care.
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Pre-Hospital Care
- Prioritize pre-hospital care to reduce preventable deaths.
- Use a simple assessment of mental status and radial pulse to determine fluid needs.
Resuscitation Fluids
- Hypertonic saline, while theoretically beneficial, showed no outcome benefit in studies.
- Whole blood is now preferred over crystalloids in prehospital settings.
Whole Blood Resuscitation
- Consider whole blood for resuscitation of bleeding trauma patients.
- Multiple trauma centers are adopting whole blood programs, showing its growing acceptance.