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.
42:54
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Quick takeaways
- Early assessment of trauma patients is essential, with a focus on vital signs and mental status to determine resuscitation needs.
- The shift towards using whole blood for resuscitation over traditional fluids is supported by military data and emerging civilian adoption.
Deep dives
Understanding Trauma Care Phases
The trauma care process is divided into distinct phases: the pre-hospital and in-hospital stages. A significant portion of preventable deaths, estimated at 80 to 90 percent, occur before patients reach the hospital, highlighting the importance of effective pre-hospital interventions. During this phase, rapid assessments including mental status and vital signs are crucial for determining the need for resuscitation. Specifically, medical personnel are advised to withhold fluids in stable trauma patients, with resuscitation commencing only when key indicators, such as mental status deterioration or absence of a radial pulse, suggest significant blood loss.
