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Trauma Guidelines

Emergency ward

FAST/extended FAST

C-circulation

Adrenergetic support- is not a rescue therapy

Active approach:

early on-early off

Adremomymetic support: don’t wait too

late

Balanced crystalloid resuscitation

Sterofundin ISO-safe decision

Осмол pH BE Глюкоза Na+ Cl- K+ Mg2+ Ca2+ Малат- Лактат Ацетат

280

300 7,5 +1 10 145 127

100 140 0 -1 4,5

5

3

3

2

2

0

10

1

0

0

30

20

Safe decision means that:

the fluid is optimal for 95% of

patients

the fluid is safe for other 5%

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no lactate

BEpot = 0 mmol/l

Balanced electrolytes

Safe corridor

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ICP-monitoring; CPP monitoring

Pressure Support with APRV

Alternative modes of ventilation - BIPHASIC, APRV

these modes of ventilation permit to solve the antagonism between MV and spontaneous breathing and the result is:

activization of spontaneous breathing

venous return cardiac output ventilation of basal parts

of lungs needs in sedation

HFOV

HFOV Conventional ventilation

HFOV

Safety window

Carney et al. Crit Care Med 2005;33:S122-S128

Unstable alveoles during CMV and HFOV

HFOV