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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Whole Blood Resuscitation
- Consider whole blood for resuscitation of bleeding trauma patients.
- Multiple trauma centers are adopting whole blood programs, showing its growing acceptance.
Pre-Hospital Monitoring
- Point-of-care lactate may be useful in pre-hospital settings with longer transport times.
- Advanced monitoring, like heart rate variability, may be the future for early identification of patients at risk.
Fluid Reflex
- Dr. Martin observed a persistent tendency to administer fluids despite permissive hypotension guidelines.
- He recounts clamping IVs only to find them reopened, highlighting the ingrained reflex to give fluids.