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Thu May 17 17:29:28 BST 2007

Very Good analgesia, ketamine with morphine works well to keep patients
still, early compression, watch urethra, low volume resuscitation,
transfuse carefully to correct coagulopathy, CT to diagnose what else is
damaged. Slow transfer.

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of MARK FORREST
Sent: 16 May 2007 22:57
To: Trauma &amp, Critical Care mailing list
Subject: RE: Level 1 Fluid Infusor

Yeah, c-clamp seems very popular in some areas and totally dismissed in
others....wonder what other list members think? It can certainly fitted
far more rapidly, but how much advantage it has over a good pelvic strap
I am not sure, especially as it can be 'in the way' for some surgical
techniques.
  Any other comments on emergency managment of massive pelvic trauma in
ER?
  Regards
  Mark F

Aruni Sen <ARUNI.SEN at new-tr.wales.nhs.uk> wrote:
  Compression with harness getting popular than exfix. Some of our
orhtopods do put exfix on. We transfuse if needed after either is on -
level 1 is quick to warm. Never need rapid infusion.
Stewart Matthews from Leeds swears by the pelvic C clamp - simpler than
exfix.

Aruni

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of MARK FORREST
Sent: 16 May 2007 15:13
To: Trauma &, Critical Care mailing list
Subject: RE: Level 1 Fluid Infusor

HI Aruni, you raise another interesting question! What is the place of
the exo-fix in the resus room, when a pelvic strap will usually do
during the resus phase, until a definitive procedure can be perfomed in
the OR, where the Level-1 lives!

We recently audited every orthopod on call in our area and were quite
shocked how few had ever put on an exo-fix...let alone in an emergency
or in a matter of a few minutes.This may be one of the reasons that
blood loss is so considerable.

Cheers
Mark F

Aruni Sen wrote:
Not such an absolute truth. 

We do need level 1 very occasionally when transfusing pelvis after an
exfix/compression has been put on - not for its speed of transfusion but
for its efficacy in heating the blood.

aruni sen 
wrexham

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of MARK FORREST
Sent: 16 May 2007 00:13
To: Trauma & Critical Care mailing list
Subject: Re: Level 1 Fluid Infusor

No place for level-1 in resus room unless you plan to operate there! If
they are bleeding that much then they should be in the OR or at least on
the way. Takes time to set-up, delivers excessive amounts of fluid and
it slows down transport to theatre. Keep it in theatre!
Mark F
ATACC UK

----- Original Message ----
From: "Offner, Patrick" 

To: "Trauma & Critical Care mailing list" 
Sent: Tuesday, 15 May, 2007 8:33:44 PM
Subject: RE: Level 1 Fluid Infusor

We have one and use it in patients who require massive transfusion--more
so in the OR rather than in the ED. We also use it for continuous
arterio-venous rewarming of hypothermic patients.

Pat

________________________________

From: trauma-list-bounces at trauma.org on behalf of kmattox at aol.com
Sent: Tue 5/15/2007 12:09 PM
To: Trauma & Critical Care mailing list
Subject: Re: Level 1 Fluid Infusor

We bought one when our hands were slapped because we did not have one in
opur EC. That happened during a trauma center revoew. We have never
used it in the EC and have rarely used it in OR. It makes a good coat
rack. These kind of devoices contribute to fluid overload. 

K

Sent via BlackBerry from Cingular Wireless 

-----Original Message-----
From: Krin135 at aol.com
Date: Tue, 15 May 2007 13:58:18
To:trauma-list at trauma.org
Subject: Re: Level 1 Fluid Infusor

In a message dated 15-May-07 12:54:24 Central Daylight Time, 
cmursic at gmail.com writes:

http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2007-May/_http://www.smiths-medical.com/catalog/fluid-warming/fast-flow/hardware/
level-
1-h-1200.html_
(http://www.smiths-medical.com/catalog/fluid-warming/fast-flow/hardware/
level-1-h-1200.html)

or http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2007-May/_http://tinyurl.com/y4jlxn_ (http://tinyurl.com/y4jlxn)

for those who have trouble seeing the original link in Dr. Ursic's
post..

and I doubt that I'll ever see one, much less use one...

ck
Charles S. Krin, DO FAAFP

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Level 1 Fluid Infusor