medcitool

We use dopamine, dobutamine, epi and vasopressin. No real difference in my opinion with epi and vasopressin. However dopamine sucks for acute MI bradycardia and dobutamine is great was restoring hemodynamic stability in that situation with cardiotoxic effects like dopamine. Don't know what else to say.

I am not a fan of LBB and collar for every trauma in the world but this took me by surprise. I come from an area that has specific no board or to board policies. We get certified in the art of removing a pt. from a c-spine status. I don't know why but we have to do it. It's actually easy and uses common sense and is the same thing the doc's do. How many of you guys have seen the doc's remove a LBB and collar from a pt. without x-ray or CT. Happens all the time. Anyway away from that is the PHTLS guidelines. I asked a trauma doc this very question. Answer is simple. The potential injury from a GSW is nearly immediate according to research and the potential for further injury without c-spine precautions is nearly nothing. I have not found research to substantiate that claim but I continue to look. Because of the pentrating aspect of the injury the body almost self corrects per say. In blunt force there is great potential for swelling and spinal cord compression. Thus a LBB in this situation is recommended due to movement with swelling resulting in possible compression. That is the difference between blunt and penetrating. If you have further specific questions let me know and I will ask.