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It is very hard to say given the scenario. Allot of what you will do will depend on the extent of injuries, amount of supplies on hand, number of casualties and their injuries, and the clinical presentation of the patient in question. People with extensive hepatic, renal, splenic, and vascular injuries need definitive care (surgery), so in amultiple casualty situation a patient with unstable vital signs and penetrating abdominal trauma may recieve less attention than casualties with more controllable problems, ie extremity hemorrhage. The US Army Casualty Care Course (TC3) may start teaching that careful oral rehydration of trauma patients with a stable airway, intact mentation, and lack of nausea can benefit the patients. I do not know if this is officially being taught but I have the information and proposed updates, and was taught this in a reacent TC3 train the trainer course that I attended. The rationale behind keeping trauma patients NPO is related to two things, 1. Keeping an empty stomach to reduce problems with gastric regurgitation during intubation, and prevent airway collapse from gastric regurgitation, or emesis in a nauseated trauma patient. I guess it really comes down to doing what you can given the situation. If you are intrested I would be more than happy to email some of the TC3 information to you. I hope this helps, cbare.
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