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Trauma Question for Rid (Dust and others)


strippel

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Good point Race. The kidneys can take a hit even with one short episode of hypotension. If the brain and the beans are perfused everything else will take care of itself.

Live long and prosper.

Spock

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I agree that it doesn't mean you have to run fluids through at all let alone wide open. I would think the thought process would be something to the effect that it's better to get a peripheral line while they have circulating volume before they go flat due to hypovolemia.

Spock, why are you guys pulling the prehospital IV's?? And, do you not subscribe to a targeted MAP of 90 mmHg in TBI to maintain proper CPP (without knowing what the exact ICP is)?

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the hospital I work at (level II) we like 2 large IVs on all bad trauma pts, GI bleeds, anemics and others who will probably need blood. we dont hassle EMS for not getting 2 lines, although i think we should sometimes. we have a couple of flight crews that come in with a 20g in a hand and I float in 16's with my eyes closed.

anyhow, yes, i think trauma pts need 2 large bore IVs locked. i dont know how many times we've gotten a pt in, seemed stable, got the go ahead from the doc, threw in the 2 large bores, locked em, and bee bopped to CT with a nurse and myself and the pt crashed in the scanner.

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