Journal of the Royal Army Medical Corps
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Although recent studies have shown that the timing of volume replacement deserves careful consideration (56), which fluid to use is less clear, with the perennial debate of crystalloid v colloid and now colloid v colloid still unresolved. This review has examined three sugar solutions, two colloids and one crystalloid. In general, all three agents are unhelpful in the immediate resuscitation of hypovolaemic trauma by virtue of a combination of pathophysiology and side effects. Dextran solutions and mannitol are useful in specific situations.
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The optimal fluid for the resuscitation of critically ill and injured patients remains the subject of considerable controversy. Hypertonic crystalloid solutions such as hypertonic saline provide rapid volume expansion, have an acceptable safety profile, and are easy to store and transport. Recent meta-analyses suggest a trend toward increased survival in patients given hypertonic saline, and it has been suggested that they may have particular benefit in certain groups of patients such as hypovolaemic head injury patients. This short review examines the physiological and experimental evidence supporting the use of hypertonic saline in fluid resuscitation.
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This paper places on record the clinical activity of the hospital facilities run by 22 Field Hospital on Exercise SAIF SEREEA II in Oman from August to November 2001. There were 1322 episodes of illness resulting in a hospital admission. ⋯ The main causes of admission were gastrointestinal illness, conditions related to the heat and injuries. The reporting of health service utilisation data is an important duty of medical personnel during overseas deployments in order to add to the dataset available for the estimation of medical workload for future operations.