Combat Trauma Lab (@combattraumalab) 's Twitter Profile
Combat Trauma Lab

@combattraumalab

The latest research merged with combat experience in the hopes of saving lives.

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linkhttp://www.CombatTraumaLab.org calendar_today09-01-2020 03:16:12

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🛡️ Prevention is always better than cure but sometimes you don't have a choice.  🔥 In that case we go into damage control mode in which we try to take more aggressive steps to correct the issue.

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🩸ABO and Rh blood type system are major classifications of human blood based on the presence or absence of specific glycoproteins molecules on the surface of red blood cells. These act as antigens, triggering an immune response if incompatible blood types are mixed.

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📓Protocols vary, but plasma is usually used in conjunction with pRBC as primary volume resuscitation fluids. ❗ RBC: plasma ratios closer to 1:1 = better outcomes. 🤔 If your trauma patient is getting > ~2 units of RBCs, you may want to consider if they may benefit from plasma.

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⌛Burn shock typically develops over a longer period, think 6-8 hours post-injury. Therefore, if you see immediate hypotension in a burn victim, it should prompt consideration and evaluation for other potential causes.

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Whole Blood – the original lifesaver in our blood product lineup!  It contains every element of blood, making it a balanced option. Because its "all-in-one" it means we can more rapidly get "all the things" in.  We give less "fillers" (ie citrate anticoagulant and substrate)

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Remember: 🚫 Not all pneumothorax develops tension physiology 🚫 Not all penetrating trauma have a PTX 🚫 Needle will not fix most causes of shortness of breath/ dyspnea/hypoxia Needle decompression is a 1 trick 🎠, use it only when needed to prevent doing more harm then good.

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A brief overview of "Moving the needle on time to resuscitation: An EAST prospective multicenter study of vascular access in hypotensive injured patients using trauma video review."  PMID: 37012624 Does this change your practice?

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Intraosseous (IO) can be great. But many myths exist in regards to what you can use them for. IO are fine for: 1. Blood 2. Fluids 3. Basically just about any medication 4. Lab Draws: Note WBC, K, Na and Ca can be slightly off, butmost other values work just fine.

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📚 Prehospital Extended FAST Exams Improve Clinical Decision Making by Helicopter EMS Crews: A Retrospective Case Series. Prehospital Emergency Care- Feb 2024 ❓What do you think of the study? ❓Does U/S have a role prehospital?

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Navigating Pneumothorax Detection Methods: 🚑🔍 ❓How do you feel about your clinical evaluations for finding PTX? ❓Are you a fan of U/S for this?

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📉 Though uncommon, it demands vigilance due to its high mortality rate if untreated. 🧐 Especially after major blasts or trauma, keep a keen eye out. Symptoms might be subtle until they're not. ❓How did your last tension PTX present? ❓ What prompted you to intervene?

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Needle Decompression & Chest Tube Insertion: A Technique Quick Tip   Always go OVER the rib to access the thoracic cavity. 🚫 Avoids the neurovascular bundle located under each rib. 🦴 Palpate for the ribs before sticking. It's 💯% fine to hit the rib then go over.

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⚓Fun fact: Damage control is a term coined by the Navy.   It's important to understand that DCR isn't a single magic bullet. It's a comprehensive strategy, an overarching theme guiding the treatment of critically injured patients.

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Pharmacokinetics of Tranexamic Acid (TXA) Delivered by Expeditious Routes in a Swine Model of Polytrauma and Hemorrhagic Shock. Prehosp Emerg Care. 2024.  doi: 10.1080/10903127.2024.2342025

Pharmacokinetics of Tranexamic Acid (TXA) Delivered by Expeditious Routes in a Swine Model of Polytrauma and Hemorrhagic Shock. Prehosp Emerg Care. 2024. 

doi: 10.1080/10903127.2024.2342025