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They had two large bore IV's and the air crew was starting a third just in case. The patient was on hundred percent O2 by FM. At the referring ED, they stated that he had breakthrough bleeding and they had to reinforce the bandage twice. The air crew stated that after he arrived to us he had lost at least 2 liters of blood in the ED and on the gurney in their helicopter. The patient had a RR of 40 breaths per minute and was cold and sweating. The air crew was calling stating that they were giving more fluid boluses and starting the blood. They also notified us that they were going to apply a tourniquet to the thigh.
We upgraded the patient from consult status to our highest level of activation and the trauma team was waiting for the patient on arrival in the trauma bay.
Thoughts? What about the blood? Would you or would you not transfuse? What are your triggers?
Tourniquet? Yes? No? Maybe?
Another adjuncts? Hemcon? Quikclot? Other topicals?
I am going to post two photos I took in the midst of the fray. I have blocked out the patient's face and doctor's partially masked face so not to reveal identities or give identifying information.
Dutch
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