Quote:
Originally Posted by 11Ber
Thats what I get for not doing math. I added flight time total to 32...forgot about the damned return flight.
Brush Okie - As for fluids, Hextend is the current TCCC recommended fluid in the absence of FWB or blood products and signs of hypovolemic shock. You can look the protocol up but it is 500cc bolus up to 1L total. Since I am running this in my mind as an 18D I go with the 500 of Hextend. Not so much to cause a huge shift in electrolytes but enough to give his BP a boost. Monitoring blood pressure will let me know if I have bleeding in the box and then we have bigger issues.
I have argued this several times with a general physician/professor in my college program because he still recommends high flow O2 and 2L NS. I have presented the studies I have found with no effect. I will put several of the O2 studies below.
As for C-Spine...nothing tells me he has C-spine issues. Several years ago I sat on a lecture by a doctor from Baylor on the history of and issues with the C-Collar. It was introduced into emergency medicine with no studies proving either its need or efficacy. He and his colleagues have studied it in depth and found multiple issues with its use. The one that sticks out is spinal cord death due to strangulation from being stretched in the C1-C2 region. I will also put that below.
Again, I am only looking at this from the eyes of a SF Medic not an EMT or paramedic. Hopefully this stimulates some good discussion.
C-Collar: https://www.google.com/url?sa=t&rct=...45645796,d.dmQ
Pre-Hospital O2 in trauma: http://www.ncbi.nlm.nih.gov/pubmed/15379072
TCCC - http://www.naemt.org/Libraries/PHTLS...%20120917.sflb |
I saw the Baylor and Israeli studies as well. Really makes you think twice. Would love to see more published on c-collar results. The fluid resuscitation is generating discussion as well, but there at least the indicators could lead you through a logical choice and monitor results. C-collar not so much from the available studies.