Thread subject: NEPI :: Trauma and Fluid resuscitation

Posted by imron on 06-02-2008 20:30
#2

A - Clear
B - Clear
C - Normal (Tachycardia maybe due to pain or irritability)
or
Class 1 or Class 2 shock (Blood loss upto 1500ml may manifest with only tachycardia with normal blood pressure)

I would give the patient a fluid bolus of about 500-1000ml crystalloid while getting a FAST scan as well as the trauma series of xrays. (C-spine, Chest and Pelvis)

I would give a dose of opioid or NSAID IV

I would have a extra look at the cardiac contractility during the FAST scan to rule out any LV dysfunction.

The goal is to ensure that urine output is atleast 0.5ml/kg/hr whether the fluid bolus is required or not.

If all seems well, the normal daily requirement of fluids must be started. Eg:- Normal Saline at 100ml/hr. (Dextrose containing solutions must be avoided in normoglycemic acute brain injured patients.)