An Assault on Preventable Trauma Deaths With Andrew Fisher

Join us as we interview Andrew Fisher on the multiplicity of managing civilian trauma patients. Although the complexity of trauma management is often understated, the basics are often not managed appropriately, and can have an appreciable affect on trauma outcomes.


We discuss TEG, blood product administration, acute trauma coagulopathy, the MARCH algorithm, and when it comes to permissive hypotension, just how low can you go?

References

  • Brohi, K., Gruen, R. L., & Holcomb, J. B. (2019). Why are bleeding trauma patients still dying? Intensive Care Medicine. https://doi.org/10.1007/s00134-019-05560-x
  • Davenport, R. A., & Brohi, K. (2016). Cause of trauma-induced coagulopathy. Current Opinion in Anaesthesiology. https://doi.org/10.1097/ACO.0000000000000295
  • Frith, D., & Brohi, K. (2012). The pathophysiology of trauma-induced coagulopathy. Current Opinion in Critical Care. https://doi.org/10.1097/MCC.0b013e3283599ab9
  • Harris, T., Thomas, G. O. R., & Brohi, K. (2012). Early fluid resuscitation in severe trauma. BMJ (Online). https://doi.org/10.1136/bmj.e5752
  • Huebner, B. R., Dorlac, W. C., & Cribari, C. (2017). Tranexamic Acid Use in Prehospital Uncontrolled Hemorrhage. Wilderness and Environmental Medicine. https://doi.org/10.1016/j.wem.2016.12.006
  • Kyle, T., Greaves, I., Beynon, A., Whittaker, V., Brewer, M., & Smith, J. (2018). Ionised calcium levels in major trauma patients who received blood en route to a military medical treatment facility. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2017-206717
  • McGinity, A. C., Zhu, C. S., Greebon, L., Xenakis, E., Waltman, E., Epley, E., … Jenkins, D. H. (2018). Prehospital low-titer cold-stored whole blood: Philosophy for ubiquitous utilization of O-positive product for emergency use in hemorrhage due to injury. The Journal of Trauma and Acute Care Surgery. https://doi.org/10.1097/TA.0000000000001905
  • Nevin, D. G., & Brohi, K. (2017). Permissive hypotension for active haemorrhage in trauma. Anaesthesia. https://doi.org/10.1111/anae.14034
  • Raza, I., Davenport, R., Rourke, C., Platton, S., Manson, J., Spoors, C., … Brohi, K. (2013). The incidence and magnitude of fibrinolytic activation in trauma patients. Journal of Thrombosis and Haemostasis. https://doi.org/10.1111/jth.12078
  • Sperry, J. L., Guyette, F. X., Brown, J. B., Yazer, M. H., Triulzi, D. J., Early-Young, B. J., … Zenati, M. S. (2018). Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1802345
  • Stensballe, J., Baksaas-Aasen, K., Juffermans, N. P., Brohi, K., Naess, P. A., Stanworth, S., … van Dieren, S. (2019). Towards patient-specific management of trauma hemorrhage: the effect of resuscitation therapy on parameters of thromboelastometry. Journal of Thrombosis and Haemostasis. https://doi.org/10.1111/jth.14378
  • Wafaisade, A., Lefering, R., Bouillon, B., Böhmer, A. B., Gäßler, M., & Ruppert, M. (2016). Prehospital administration of tranexamic acid in trauma patients. Critical Care. https://doi.org/10.1186/s13054-016-1322-5

Curbside to Bedside

Curbside to Bedside is a blogcast created by front line EMS Clinicians to provide simple and relevant initial and continuing prehospital EMS education.

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