Thread subject: NEPI :: Trauma and Fluid resuscitation

Posted by maroju on 06-02-2008 17:24
#1

Guys, here's one more acute scenario. I would very much appreciate your ideas on this. (Trauma surgeons, intensivists, anaesthetists... your opinions too please...)

A patient with polytrauma following a road traffic collision is brought in by ambulance.

Airway: Patent
Sats of 96% (15 ltrs O2 with non re-breathing mask)
RR: 18/min, Good and equal air entry into both lungs
PR: 110, CR<2 secs, MAP=90 mmhg
GCS: 13/15 (E3:V4:M6), PERLA (3mm)

What fluids and how much of it would you give? Would you go entirely by the ATLS principle of hypotension in trauma = hypovolemia, and thus fill him up. Or would you do anything different? Have got any local guidelines? How would you monitor and decide further management?