J Trauma
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Hypercoagulability is a major source of morbidity and mortality after injury. A resuscitation regimen that modulates this coagulopathy may prove beneficial. We sought to evaluate the effects of lactated Ringer's (LR) solution and Hextend on the resuscitation of uncontrolled hemorrhagic shock. ⋯ Modulation and restoration of normal coagulation is critical in the management of trauma patients. The patient's coagulation profile might determine the type of fluid to be used at various times during their course. Thrombelastography is superior to routine coagulation assays for the detection of a hypercoagulable state. Resuscitation with Hextend results in a decreased fluid requirement and attenuation of hypercoagulability after injury without increased blood loss.
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Substance abuse is one of the most prevalent comorbid conditions among trauma patients. Research has shown that injury can be reduced when brief interventions are provided to trauma patients who are hospitalized for substance abuse. This article presents data from a Level I trauma center that provided brief interventions daily over a 5-year period. A generic model for brief intervention is described, along with concrete details of this addiction intervention service.