trauma

Included below is a summary of numerous blog posts and podcasts that discuss the sometimes controversial issue of permissive hypotension or minimum volume resuscitation in the bleeding trauma patient.

The Basics

• Idea of keeping BP low in traumatic hemorrhage to avoid “popping the clot”
• Based mostly on data from animal trials and penetrating trauma in humans
• Common practice in most major trauma centers in USA
• The exact approach still remains controversial around the world

Disclaimer: These are highlights as interpreted by the author of this article and should not replace listening to the original podcast or reviewing the background research.  Posts are in chronological order and many of the below podcasts go beyond the scope of permissive hypotension. […]

“There has been ongoing controversy regarding the ratio of components that should be given during massive transfusion”

How do you avoid inducing a coagulopathy in trauma patients requiring massive blood transfusion? Zach Radwine, MD summarizes the recent evidence for the 1:1:1 ratio.

“The clinical picture is a mix of ARDS and air embolism”

Zara Mathews, MD covers the subject of blast injuries, including a review of the basics, important updates in the workup of these patients (for example, tympanic membrane rupture is not a great predictor of injury), and common pitfalls in management.