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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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martes, 17 de mayo de 2016

Buy time in bleeding trauma

Buying time in bleeding trauma stemlyns
St.Emlyn’s - May 16, 2016 - By Dan Horner
"Bleeding in trauma has had a lot of press recently. In Europe we have had several international consensus guidelines published on the topic. Unfortunately, these guidelines (published the same year) have contradicted each other a little, as Ian pointed out previously. Usually that means there is ongoing debate about best practice. And where there is debate there is St Emlyn’s…… 
The juiciest discussions include the use of fluids, vasopressors and resuscitation endpoints. This mirrors a lot of current UK practice – cystalloid, metaraminol and lactate debates continue to go on up and down the country in resus rooms; I am sure you’ve seen someone brandishing a syringe/fluid bag and looking overconfident recently. Interestingly, whilst the guidelines offer clear recommendations one way or the other about these contentious points they often don’t go into great detail about the first principles, or the why... 
This post is designed to make us stop and think about resuscitation. It’s not designed to be definitive, rather it’s a reflection on our understanding of resuscition, fluids, vasopressors and trauma. We welcome your thoughts and ideas. For what it’s worth, here are some thoughts from the critical care side of West Virchester…"