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crushing case

Errington Thompson errington at erringtonthompson.com
Sun Apr 15 17:31:53 BST 2012


I'm soo confused. We have a blunt trauma patient who is hypotensive, pulseless and intubated. We are saying that this patient should get no fluids?? Really?

Errington C. Thompson, MD
Trauma/Critical Care
Sent from my iPad

On Apr 14, 2012, at 7:31 PM, kmattox at aol.com wrote:

> As presented       do quick ekg     if not tigjt ekg pattern pronounce patient dead      if tight ekg either intubate and fo thoracotomy by surgeon stat or pronounce him dead.    
> 
> No pericardiocentesis .    No fluid challinge        No fluids at all at this point       .   Quick cardiac echo is ok, but verq quick.
> 
> k
> 
> Sent from Samsung tablet
> 
> Sahaj Khalsa <sahajs at gmail.com> wrote:
> 
>> This raises a question from a field provider.  As a paramedic, should
>> sodium bicarb play any role in the resuscitation of this individual?
>> Assuming a longer transport time to an ER.
>> 
>> Bicarb has always been discussed (to my knowledge) in this type of
>> resuscitation, given the (presumed) acidotic state that led to the arrest.
>> 
>> Is this correct or incorrect logic?
>> 
>> Sahaj Khalsa
>> 
>> On Sat, Apr 14, 2012 at 5:09 PM, Scott Bricker <scottbricker at verizon.net>wrote:
>> 
>>> On arrival, do pericardial ultrasound. If there is cardiac motion, do
>>> resuscitative thoracotomy. If there is no cardiac motion, pronounce the
>>> patient dead.
>>> 
>>> Scott Bricker, MD
>>> Harbor-UCLA Medical Center
>>> 
>>> Connected by DROID on Verizon Wireless
>>> 
>>> -----Original message-----
>>> From: Errington Thompson <errington at erringtonthompson.**com<errington at erringtonthompson.com>
>>>> 
>>> To: trauma-list at trauma.org
>>> Cc: trauma-list at trauma.org
>>> Sent: Sat, Apr 14, 2012 22:52:10 GMT+00:00
>>> Subject: Re: crushing case
>>> 


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