J Trauma
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The hypothermic effect of resuscitation solution temperature on epicardial and core temperatures in 15 dogs during hemorrhagic shock was studied. Hemorrhagic shock was induced and dogs were then resuscitated with either body-temperature lactated Ringer's, room-temperature lactated Ringer's, 4 degrees C blood, warmed blood, or cold blood mixed with 50 degrees C lactated Ringer's. ⋯ Baseline temperatures were not significantly changed with the use of warmed blood or body-temperature lactated Ringer's. The results of this study support the use of warmed blood or body-temperature lactated Ringer's during resuscitation from hemorrhagic shock.
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Ninety consecutive patients between 2 and 15 years of age sustaining gunshot wounds were analyzed and a management algorithm evolved. Key management steps included fluid resuscitation in the field by trained paramedical personnel and recognition of the severity of the wound when large-caliber or shotgun injuries were encountered. ⋯ Any hospitalization beyond 2 weeks' duration should have social service, home-bound school service, psychiatry, and physical therapy in consultation. During a 5-year period only two of the 90 patients died secondary to hemorrhagic shock.
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Metropolitan Houston with a population of four million has the nation's poorest freeway system. Its two Level I trauma centers are adjacent within a centrally located freeway loop, therefore the city is ideally suited for a trauma scene helicopter transport service. During 1981 there were 577 flights to the scene of injury (blunt, 466; penetrating, 111). ⋯ Scene treatment (intubation, hyperventilation and, when appropriate, mannitol administration) was routinely initiated for patients with severe head injuries. Two hundred seventy-nine patients required cardiopulmonary resuscitation, tracheal intubation, chest-tube placement, or other invasive procedures. Based upon these resuscitative efforts and invasive procedures, a physician in attendance was deemed medically desirable for one half of the flights.(ABSTRACT TRUNCATED AT 250 WORDS)