From the 8th – 12th August, we held a 'clinical week' on the subject of Critical Haemorrhage. All our posts were tailored to the subject, and we published a number of case studies and blog entries by various guest writers.
You can see the posts and discussions on our Facebook page, and by searching #CritHaemWeek on Twitter.
Below is a summary of each day. Thanks to everyone that got involved!
Monday – Assessment
We started the week with a lecture by Karim Brohi, discussing how trauma management has developed over the past couple of decades. Our case study (1) then triggered some interesting discussion around the management of shotgun injuries.
Probably the most engaging day of our #CritHaemWeek, on Thursday we covered the use of intravenous fluids and permissive hypotension. Following a lecture on the subject by Karim Brohi, we had a particularly lively discussion about the application of permissive hypotension in a cerebrating patient with severe haemorrhagic shock. There was some debate about whether to titrate fluid boluses to achieve a target blood pressure, or to withhold fluid as the patient was cerebrating. The general consensus was to withhold fluid, however a number of people (including Karim Brohi) said they would titrate as the pressures would likely drop.
On the final day of our #CritHaemWeek we had a look at the future of trauma and learned the ‘inconvenient truth’ that perhaps major trauma is not just a disease of young men. Our discussion was based on triage considerations in patients with poly-system trauma and highlighted the need for damage control surgery.