Go Back   Professional Soldiers > TMC 14 > Vital Signs

Reply
 
Thread Tools Display Modes
Old 06-30-2013, 15:19   #1
MAB32
Guest
 
Posts: n/a
Doc, right or wrong or a little of both?

Is this Doctor right or wrong or a little of both? This is as far as his fluid replacement. NOTE: Some graphic photos.

www.*******.com/watch?v=tku8YI68-JA

Last edited by MAB32; 06-30-2013 at 15:22.
  Reply With Quote
Old 06-30-2013, 15:55   #2
swatsurgeon
Guerrilla Chief
 
swatsurgeon's Avatar
 
Join Date: Jul 2004
Location: Phoenix, AZ
Posts: 880
What we have learned from military surgical procedures for penetrating trauma is, and I will use my own phrase, : red and yellow save a fellow, clear can kill you.
Packed red blood cells and Fresh frozen plasma in a 1:1 or 1:1.5 ratio does the best job with platelets every 6th unit blood given. Limiting the IVF to less than 2 liters for my cases is the goal and patients do better.
The anesthesiologist has too much IVF for that case IMO. We are also using adjuncts; TXA, PCC, Factor VIIa, etc.
That video has been around and I always enjoy those docs or others that have never operated on the human body explaining just how the body reacts, looks and is injured from their vantage point.

ss
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )

Education is the anti-ignorance we all need to better treat our patients. ss, 2008.

The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
swatsurgeon is offline   Reply With Quote
Old 06-30-2013, 17:18   #3
MAB32
Guest
 
Posts: n/a
Thanks ss!
  Reply With Quote
Old 07-01-2013, 09:53   #4
miclo18d
Quiet Professional
 
miclo18d's Avatar
 
Join Date: Mar 2012
Location: Tampa, FL
Posts: 1,505
This doc was spot on with modern medicine techniques (not sharpshooting specific doses, calibers, weapons and such). This was TCCC that I was learning in 2000 at SOCM/SFMS. The Blood/platelet/clotting factor stuff started gaining traction in TCCC around 2005-2006. Wound ballistics info was consistent from when I went to SOT in 93 and 18D course in 2000.

Fluid replacement theory is that clotting factors work better at lower pressures (below 90mmHg) than higher pressures that tend to blow the clot out. You sustain your Pt at lower Systolic BP so that the wound can clot faster and better. As far as pre-op care goes we do this with Tourniquets and monitoring BP with IV therapy titrated to maintain proper BP.

He mentioned an important factor that I have stressed in other medical threads and that is WATER DOES NOT TRANSPORT OXYGEN. Stop bleeding immediately, use fluids to maintain BP, but get blood into the Pt ASAP.

Something else I found of good value was the explanation of entrance/exit wounds. Bullets do crazy things and you will not always get the --entrance here...straight thru...exit here-- Get as much of the clothing off of your Pt so you can find ANY injury and get the holes plugged!
__________________
"The rifle itself has no moral stature, since it has no will of its own. Naturally, it may be used by evil men for evil purposes, but there are more good men than evil, and while the latter cannot be persuaded to the path of righteousness by propaganda, they can certainly be corrected by good men with rifles." Jeff Cooper
miclo18d is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump



All times are GMT -6. The time now is 00:13.



Copyright 2004-2019 by Professional Soldiers
Site Designed, Maintained, & Hosted by Hilliker Technologies