AANA journal
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In summary, although the prognosis for the severely head-injured patient may be poor, there are a multitude of techniques available to the anesthetist for minimizing the occurrence of secondary head injury. Aggressive resuscitative efforts toward maintaining homeostasis must be directed at cardiovascular and neurological systems. Sound knowledge of physiologic principles and the clinical application of these principles are essential to the safe management of a patient who has sustained traumatic head injury.
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Regardless of the means used to estimate blood loss, clinical observation of the patient with frequent assessment of cardiovascular status is that basis of total management. It is very important that EBL be reported with some accuracy using a device that has the ability to weigh blood loss. Why? The overall mortality rate from blood transfusion has been reported to be as high as one death per 5000 units given. ⋯ However, the most common pattern would be one in which a patient received many units of blood and still died as a result of his primary disease. Until recently, blood loss determination was merely a function of estimation or clinical observation due to the previously mentioned drawbacks of manual scale systems. With new advances in computers, the ease at which blood soaked sponges can now be weighed and calculated can be as simple as a touch of a button.