Trauma (haemorrhage hypovolaemia) Flashcards
what is the target scene time for a non-trapped major trauma?
<20 mins
can you request the delivery of blood products?
yes, if the patient is trapped with suspected internal bleeding
how can you assess if the pt has a SBP <70
the pt will often present with absent radial pulses and decreased alertness
when should you consider tension pneumothorax?
always consider TPT, particularly in a patient with chest injury with IPPV or persistent hypotension despite fluid therapy
should you delay transport for IV therapy in haemorrhage hypovolaemia?
No
Can you administer PRBC to a child <18yo
only if a parent/legal guardian can be contacted and consents
Recite the Haemorrhagic Hypovolaemia CPG
What conditions must NOT be treated in the haemorrhagic hypovolaemia guideline
- TBI
- isolated SCI
- APH (ante-partum)
- PPH
What must you manage before continuing with the haemorrhagic hypovolaemia guideline?
- TPT
- significant pain
- environmental exposure
What treatment is required for a patient with a SBP >70
- tolerate hypotension without fluid for up to 2 hours
- prepare for deterioration
- consult with clinician or receiving hospital for management IF:
- prolonged pre-hospital times
- prolonged extrication
- elderly/frail patients
What treatment is required for a patient with a SBP <70
- prioritise immediate transport
- Normal Saline 250mls
- repeat 250mls (up to max of 2000mls)
- Titrate to SBP >70
- Consult for further management if inadequate response
- Consider availability for blood products
Why don’t we give fluid if the patients SBP is over 70?
- permissive hypotension
- the act of maintaining a blood pressure lower than physiologic levels in a patient that has suffered from haemorrhagic blood loss
- it is employed to maintain adequate vasoconstriction, organ perfusion and prevent undesired coagulopathy
