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Prehospital blood produce administration

Bijan Shams Kheirabadi, Nahir Miranda, Irasema B Terrazas, Mary D Gonzales, Rose C Grimm, Michael A Dubick
BACKGROUND: Prehospital, small-volume resuscitation of combat casualties with a synthetic colloid (6% hydroxyethyl starch [HES] 670/0.75) has been recommended when blood or blood components are unavailable. We studied hemostatic effects of a newer synthetic colloid (6% HES, 130/0.4) compared with either a natural colloid (albumin) or to crystalloids in an uncontrolled hemorrhage model. METHODS: Spontaneously breathing New Zealand white rabbits (3.4 ± 0.1 kg) were anesthetized, instrumented, and subjected to a splenic injury with uncontrolled bleeding...
January 2017: Journal of Trauma and Acute Care Surgery
Li Yuxiang, Tang Lu, Yu Jianqiang, Dai Xiuying, Zhou Wanfang, Zhang Wannian, Hu Xiaoyan, Xiao Shichu, Ni Wen, Ma Xiuqiang, Wu Yinsheng, Yao Ming, Mu Guoxia, Wang Guangyi, Han Wenjun, Xia Zhaofan, Tang Hongtai, Zhao Jijun
BACKGROUND: Procedural burn pain is the most intense acute pain and most likely type of burn injury pain to be undertreated due to the physician's fear of the adverse effect of analgesia and lack of anesthetist present. At our institution, in most of the cases, local burn detersion and debridement were performed at the ward level without any analgesics. This article describes a study designed to test the analgesia effect of a fixed nitrous oxide/oxygen mixture on burn dressing pain. METHODS/DESIGN: The experiment was carried out in three centers...
2012: Trials
Richard Lammers, Maria Byrwa, William Fales
OBJECTIVES: Systematic evaluation of prehospital provider performance during actual resuscitations is difficult. Although prior studies reported pediatric drug-dosing mistakes and other types of management errors, the underlying causes of those errors were not investigated. The objective of this study was to identify causes of errors during a simulated, prehospital pediatric emergency. METHODS: Two-person emergency medical services (EMS) crews from five geographically diverse agencies participated in a validated simulation of an infant with altered mental status, seizures, and respiratory arrest using their own equipment and drugs...
January 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Steven Johnston, Garry J Wilkes, Jennifer A Thompson, Mel Ziman, Richard Brightwell
OBJECTIVE: This study analysed the analgesic effect and changes in vital signs associated with administration of inhaled Methoxyflurane (MTX) and/or intranasal Fentanyl (INF) for prehospital management of visceral pain. METHOD: A retrospective, observational study reviewing 1024 randomly selected records of patients with presumed visceral pain administered MTX (465), INF (397) or both (162) by the Western Australian Ambulance Service between January 2004 and February 2006...
January 2011: Emergency Medicine Journal: EMJ
Alex B Valadka, Claudia S Robertson
The last 30 years have been both exciting and frustrating for those in the field of traumatic brain injury (TBI). Much has been learned, but no new treatment has been shown to improve patient outcomes despite the execution of many clinical trials. The overall incidence of TBI has decreased, probably because of intensive efforts toward prevention and education. Rigorous assessment of available research has produced several evidence-based guidelines for the management of neurotrauma patients. The creation of organized emergency medical services systems in many regions has improved prehospital care...
July 2007: Neurosurgery
E R Gonzalez, J P Ornato
The objective of vasopressor therapy during closed-chest cardiopulmonary resuscitation (CPR) is to augment coronary perfusion pressure so that spontaneous circulation can be reestablished. Epinephrine, an endogenous catecholamine with both alpha- and beta-adrenergic activity, is the vasopressor of choice for use during CPR. Epinephrine's potent alpha1-and alpha2-adrenergic effects improve cerebral and myocardial blood flow by preventing arterial collapse and by increasing peripheral vasoconstriction. The optimal dose of epinephrine in humans during closed-chest CPR is unknown...
July 1991: DICP: the Annals of Pharmacotherapy
M Rocha e Silva, I T Velasco, M F Porfirio
Hypertonic saline, or saline-dextran resuscitation is normally achieved with an Na+ load of 4.8 to 7.2 mEq/kg given in a small volume (typically 4 to 6 ml/kg NaCl 7.5%). Na+ can also be administered saturated in a smaller volume, e.g., 1 to 1.5 ml/kg NaCl 25%, with similar results. Such reduction in administered volume would be an asset in prehospital trauma management. In the present experiments, severely bled (45 ml/kg) dogs were treated with one of three NaCl/dextran-70 solutions: S1, 25% NaCl + 24% dextran (1...
February 1990: Critical Care Medicine
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