Pitacpol

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Feliz Navidad!!!

Hoy formación se control de hemorragias con nuevos y magníficos materiales.

Manejo de lesiones penetrantes en cuello.

sjtrem.biomedcentral.com

Interesante articulo sobre la resucitacion con productos hemáticos y fluidoterapia en los conflictos de Afganistán, iraq y Siria.
https://academic.oup.com/milmed/advance-article/doi/10.1093/milmed/usab461/6477793

Trends in Prehospital Blood, Crystalloid, and Colloid Administration in Accordance With Changes in Tactical Combat Casualty Care Guidelines ABSTRACTIntroduction. Hemorrhage is the leading threat to the survival of battlefield casualties. This study aims to investigate the types of fluids and blood p

https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/medical-care-in-a-police-intervention-with-conducted-electrical-weapons-zaragoza-spain-fire-department-protocol/553E0769B42BB8F86D8B9781415B4E4C/share/b3ba3cc56fa94e5d46b121e1e1be3bda31017ef8
Recomendada lectura

Medical Care in a Police Intervention with Conducted Electrical Weapons: Zaragoza (Spain) Fire Department Protocol | Prehospital and Disaster Medicine | Cambridge Core Medical Care in a Police Intervention with Conducted Electrical Weapons: Zaragoza (Spain) Fire Department Protocol - Volume 36 Issue 5

Lectura para este veranito. Cuidadin con los bichejos!!!
https://www.academia.edu/keypass/TnJrZGo0NTBESEpqbWUzcDdzYm9ZN1FhTlhSYXU2TzQyYVlWVEFrQWpCbz0tLVVXd1AreGh3L0MzcGtaTXQwNUV4NHc9PQ==--cecfed8b97086b6a8f7be02fba19b259a628baf5/t/zcgd-PLNXr8S-0xw8H/resource/work/6649021/Guidelines_for_the_Management_of_Snake_Bites?email_work_card=title

Los tiempos difíciles crean hombres fuertes. Los hombres fuertes crean buenos tiempos. Los buenos tiempos crean hombres débiles. Y, los hombres débiles crean tiempos difíciles. Cita de G. Michael Hopf.

Algunas de las ventajas e inconvenientes del entrenamiento con Realidad Virtual
https://spark.adobe.com/post/wNgOjXpK9toel/?w=1_6342 a través de
Adobe Spark

https://twitter.com/VAUGELEN/status/1333152832174911490?s=19
Prueba del torniquete X&T

VALENTIN G. on Twitter “Hoy he probado el torniquete de SIMULANDO Simulación y Moulage el Torniquete X8T Tactical Tourniquet. ”

"2 Liters bolus at the start for a fluid challenge"

"Fill the tank with whatever fluid you have"

For years, this was gospel in trauma teaching and practice. Unfortunately, the dogma is still evident in dangerous practice patterns.

If you've spent anytime on this platform and our community, you know that I preach the antithesis of this concept.

BLEEDING TRAUMA PATIENTS:
#1 fluid of choice = WHOLE BLOOD (warm/fresh, fresh-frozen).
#2 is component therapy *see my prior massive transfusion posts.

CRYSTALLOIDS: includes Saline, LR (lactated ringers), Plasmalyte
1. Worsens acidosis (hyperchloremic with large volumes of NS) and worsens metabolic acidosis
2. No oxygen carrying capacity
3. Hemodylution
4. No clotting factors
5. Increases base deficit
6. Increased risk of multiorgan failure
7. Increased risk of wound infection
8. Increased risk of wound dehiscence
9. Risk of hypothermia if at room temp

BOTTOM LINE: INCREASED RISK OF DEATH WITH LARGE CRYSTALLOID INFUSION WITH HEMORRHAGING TRAUMA

NOTE: exacerbates "LETHAL TRIAD"
A) COAGULOPATHY
B) ACIDOSIS
C) HYPOTHERMIA

EXCEPTIONS:
1. Burn patients NOT BLEEDING need appropriate cyrstaloid resuscitation (Rule of 10s)
2. Non-bleeding patients (head trauma for example) need specific fluids like hypertonic 3%.

PLEASE LIMIT CRYSTALLOID IN CRITICALLY INJURED BLEEDING TRAUMA PATIENT!

THANKS TEAM

📷npr.org