Prehospital Damage Control: The Management of Volume, Temperature… and Bleeding!
| Autor: | José Julián Serna, Michael W. Parra, Luis Fernando Pino, Carlos A. Ordoñez, Juan José Meléndez-Lugo, Mónica Guzmán-Rodríguez, Juliana Ordoñez, Edison Angamarca, Laureano Quintero, Alberto García, Yaset Caicedo |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Damage control
medicine.medical_specialty Emergency Medical Services Choque hemorrágico Resuscitation Hemorrhage Review Hypothermia Soluciones cristaloides Vasoconstricción Trauma Compartment Syndromes Prehospital care Permissive hypotension Body Temperature 03 medical and health sciences Articulo de Revisión 0302 clinical medicine Injury Severity Score medicine Humans Atención prehospitalaria 030212 general & internal medicine Survival rate Hemorrhagic Tourniquet Blood Volume business.industry Hemostatic Techniques High mortality hemorragia 030208 emergency & critical care medicine Shock Crystalloid Solutions Bleed Tourniquets Sangrado Blood pressure Emergency medicine Reperfusion control de daños Wounds and Injuries medicine.symptom Damage Control business hipotermia Torniquetes Algorithms |
| Zdroj: | Colombia Médica : CM |
| ISSN: | 1657-9534 |
| Popis: | Damage control resuscitation should be initiated as soon as possible after a trauma event to avoid metabolic decompensation and high mortality rates. The aim of this article is to assess the position of the Trauma and Emergency Surgery Group (CTE) from Cali, Colombia regarding prehospital care, and to present our experience in the implementation of the "Stop the Bleed" initiative within Latin America. Prehospital care is phase 0 of damage control resuscitation. Prehospital damage control must follow the guidelines proposed by the "Stop the Bleed" initiative. We identified that prehospital personnel have a better perception of hemostatic techniques such as tourniquet use than the hospital providers. The use of tourniquets is recommended as a measure to control bleeding. Fluid management should be initiated using low volume crystalloids, ideally 250 cc boluses, maintaining the principle of permissive hypotension with a systolic blood pressure range between 80- and 90-mm Hg. Hypothermia must be management using warmed blankets or the administration of intravenous fluids warmed prior to infusion. However, these prehospital measures should not delay the transfer time of a patient from the scene to the hospital. To conclude, prehospital damage control measures are the first steps in the control of bleeding and the initiation of hemostatic resuscitation in the traumatically injured patient. Early interventions without increasing the transfer time to a hospital are the keys to increase survival rate of severe trauma patients.La resucitación en el control de daños debe iniciarse lo más rápido posible después de presentado el evento traumático para evitar descompensación metabólica y aumento de la mortalidad. El objetivo de este artículo es sustentar nuestro enfoque respecto a la atención prehospitalaria y presentar nuestra experiencia en la implementación de la iniciativa “ |
| Databáze: | OpenAIRE |
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