Abstract:
Management of hemorrhagic shock and airway stabilization are two pillars of trauma resuscitation which have a dependent, yet incompletely understood relationship. Patients presenting with traumatic hemorrhage may manifest shock physiology prior to intubation, conferring a higher risk of postintubation hypotension, pulseless arrest, and mortality. This case series describes of a group of seven US military members with combat-related trauma who experienced pulseless arrest after rapid sequence intubation in a role 2 or role 3 setting. All except one of the patients had hemodynamics suggesting hemorrhagic shock prior to intubation. This case series highlights the need for further research to define which trauma patients are at risk of postintubation pulseless arrest. It also focuses on the knowledge gap related to the role that delayed airway management and judicious blood product resuscitation may play in preventable death after injury.
摘要:
失血性休克管理和气道稳定是创伤复苏的两大支柱,但不完全理解的关系。出现创伤性出血的患者在插管前可能表现出休克生理,插管后低血压的风险更高,无脉冲的逮捕,和死亡率。此病例系列描述了一组7名与战斗有关的创伤的美国军事成员,他们在角色2或角色3设置中快速顺序插管后经历了无脉的逮捕。除一名患者外,所有患者在插管前都有血流动力学提示出血性休克。本病例系列强调需要进一步研究,以确定哪些创伤患者有插管后无脉搏动阻滞的风险。它还着重于与延迟气道管理和明智的血液制品复苏在伤后可预防死亡中可能发挥的作用相关的知识差距。