Traumatic injury is the leading cause of death for patients between the ages of five and 44 and accounts for 10% of all deaths worldwide. Among this 10%, 30-40% of these deaths can be contributed to uncontrolled bleeding that has the potential to be corrected in the pre-trauma center environment (Spahn et al., 2010). Various methods have been studied throughout the past 10 years to improve the outcomes of patients who suffer from massive trauma. A problem currently facing the nursing transport community is the availability of diagnostic tools and products to give the patients who present with symptoms of massive hemorrhage.
Due to the nature of health care systems, many specialties such as trauma facilities and specialized surgeons are located in large urban areas. This creates an access problem for individuals who suffer injuries in suburban and rural areas resulting in higher morbidity rates for patients further from definitive care. Recently, studies have begun to focus on alternative methods to prevent exsanguination in patients who suffer traumatic injuries where surgical intervention is beyond a practical distance for a patient to experience a positive outcome. All of the studies stated that early intervention to reduce the rate of blood loss and rapid intervention are imperative to improving outcomes.
Blood products such as packed red blood cells, fresh frozen plasma, and platelets are already commonly used in trauma patients that require volume replacement and have coagulopathy. However, the availability of these products at rural facilities and even in some urban areas can be limited considering synthetic forms of blood products are not currently being used. This leaves the supply of blood at the discretion of ...
... middle of paper ...
...from www.jems.com/magazines/2013/april
Morrison, J. J., Dubose, J. J., Rasmussen, T. E., & Midwinter, M. J. (2011, October 17). Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg, E1-E6. http://dx.doi.org/10.1001/archsurg.2011.287
Spahn, D. R., Cerny, V., Coats, T. J., Duranteau, J., Gordini, G., & Stahel, P. F. (2010, April 6). Managment of bleeding following major trauma: An updated European guideline. Critical Care, 14(2). http://dx.doi.org/10.1186/cc8943
The CRASH-2 collaborators. (2011). The importance of early treatment with tranexamic acid in bleeding trauma patients: An exploratory analysis of CRASH-2 randomized controlled trial. http://dx.doi.org/10.1016/S0140-6736(11)60396-6
What happens to dontated blood? (2014). Retrieved from http://www.redcrossblood.org/learn-about-blood/what-happens-donated-blood
The guidelines’ first focus is the definition of sepsis, which makes sense, because there is no way to effectively treat sepsis without an accurate and categorical definition of the term. The guidelines define sepsis as “the presence (probable or documented) of infection together with systemic manifestations of infection”. Such systemic manifestations can include fever, tachypnea, AMS, WBC >12k, among others; these manifestations are listed in full in Table 1 of the guidelines. The definition for severe sepsis builds on to the definition of sepsis, bringing organ dysfunction and tissue hypoperfusion (oliguria, hypotension, elevated lactate) into the picture; full diagnostic criteria is listed in Table 2. The guidelines recommend that all
A complete blood count was done for this patient upon admission in order to give a baseline to help guide his care. The blood count was also done to show how his hematological system was affected by the trauma that he suffered in the motor vehicle accident he was in. If the patient was hemodynamically unstable, he may have needed blood transfusions to bring his blood counts up. White blood cells could help to tell is the patient has an infection in his surgical wound. The patient also underwent surgery to correct the injury to his spine, causing more blood to be lost in the process. The platelet, hemoglobin, and hematocrit counts could help to show in the future if the patient is suffering from internal bleeding after the surgery he had.
BioPure Corporation, which was founded in 1984 by entrepreneurs Carl Rausch and David Judelson, is a privately owned biopharmaceutical firm specializing in the ultra purification of proteins for human and veterinary use. In 1998 Biopure pioneered the development of oxygen therapeutics using “Hemoglobin”, a new class of pharmaceuticals that are intravenously administered to deliver oxygen to the body's tissues. Biopure's two products, Hemopure for human use, and Oxyglobin for animal veterinary use, both represented a new Oxygen based treatment approach for managing patients' oxygen requirements in a broad range of potential medical applications. The factor distinguishing Biopure’s two products from other blood substitute products being developed by two possible rivals, Baxter International and Northfeild Laboratories, is that its hemoglobin based source is bovine rather than human and was derived from the blood cells of cattle. Both of Biopure’s blood substitute products were in the final stages of the approval process of the Food and Drug Administration (FDA) in 1998. Oxyglobin had just received the FDA’s approval for commercial release declaring it safe and effective for medical use. Hemopure was entering final Phase 3 clinical trials and was optimistically expected to see final FDA approval for release in 1999. The FDA approval of Oxyglobin and its possible subsequent release into the veterinary market caused concern over whether the early release of Hemoglobin would impinge BioPure’s ability to price Hemopure when the product finally received approval. Given that the two products were almost identical in properties and function, it was thought that the early release of Oxyglobin would create an unrealistic price expectation for Hemopure if released first.
The fact the patient died from internal bleeding shows there were damages. The patient’s death was directly linked to the time delay finding the proper diagnosis, and inability to find the extent of internal bleeding from which he was
The Mayo Clinic defines a blood transfusion as “a routine medical procedure in which donated blood is provided to you through a narrow tube placed within a vein in your arm”. The first human blood transfusion on record was conducted by Dr. Jean-Baptiste Denys, a French physician during the late 1600’s. Although Denys’ transfusions weren’t sound proof and often written off as unorthodox, he unknowingly ushered in a new era of medicine and laid the foundation for modern advances in Hematology. I choose this topic because I volunteer to donate blood four times a year alongside thousands of other people. On average these donations help save 4.5 million Americans that would die in a years’ time without a blood transfusion. These generous people
Sepsis is defined as an exaggerated, overwhelming and uncontrolled systemic inflammatory response to an initially localised infection or tissue injury, which may lead to severe sepsis and septic shock if left untreated (Daniels, 2009; Robson & Daniels, 2013; Dellinger et al, 2013; Perman, Goyal & Gaieski, 2012; Vanzant & Schmelzer, 2011). Septic shock can be classified by acute circulatory failure as a result of massive vasodilation, increased capillary permeability and decreased vascular resistance in the body, causing refractory hypotension despite adequate fluid resuscitation. This leads to irreversible tissue ischaemia, end organ failure and ultimately, death (McClelland & Moxon, 2014; Sagy, Al-Qaqaa & Kim, 2013, Dellinger et al, 2013).
With patient safety always being the number one priority FTR is the worst case scenario for the hospitalized patient. In an article titled “Failure to Rescue: The Nurse’s Impact” from the Medsurg Nursing Journal author Garvey explains ways FTR can occur “including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice.” Nurses are problem solvers by nature, they heal the sick and help save lives. FTR is a tragic experience for everyone involved. The recent surge in this happening across the country has given FTR cases widespread media coverage. Hospitals are trying to figure out what the root cause is and how they can be prevented. Fortunately, with the advancement of technology and extensive research many hospitals have developed action plans and procedures to help prevent the early warning signs from being
The imaging modality is determined by the condition of the patient and the specific type of injury that is most appropriate (e.g., plain-film radiography vs computed tomography (CT) scan. In order to precede the imaging procedure, the clinical capabilities to support, monitor, and treat the trauma patient as well as the availability
Many doctors have extensive trauma experience and are able in most cases to help restore normal function as well as give pain relief. The most important aspect of treating trauma is the technology to help prevent the injury from becoming a permanent or recurring problem. The purpose of a sports medicine center is to be able to provide all the necessary treatments un...
Sepsis is a life threating health condition and if not treated early can lead to shock, multiple organ failure and death (Ho, 2012). The main study of which practice has been based world-wide is the Surviving Sepsis Campaign. The Surviving Sepsis Campaign was developed to create evidence-based management guidelines. The Surviving Sepsis Campaign completed this by using an educational program to implement the guidelines by integrating their recommendations into resuscitation and management bundles (Marik, 2011). The first Surviving Sepsis Campaign Guidelines were published in Critical Care Medicine in 2004 with an updated version published in 2008 with the core of the recommendation's remained largely unchanged (Ahrens, 2011).
“Summary Report for: 29-2041.00 - Emergency Medical Technicians and Paramedic.” O*Net. 2008. Web. 18 Feb. 2010.
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture.
Transfusions of red blood cells, platelets, and plasma are critical to a patient's return to good health,
Our approach in managing wounds was far from being optimal in our own setting. After having read the article of Sibbald et al (1) and assisting to presentations during the first residential week-end, our approach at St. Mary 's Hospital Center 's Family Medicine Clinic must change. We were not classifying wounds as healable, maintenance or non-healable. We were always considering the wounds in our practice as healable despite considering the system 's restraints or the patients ' preferences. In the following lines, I will define and summarize the methods one should use in order to initial management of wounds and how to integrate it better to our site. The first goal we need to set is to determine its ability to heal. In order to ascertain if a wound is healable, maintenance or a non-healable wound.
Our home, though seemingly safe, you need to have an adequate stock of supplies in the first aid kit in a place accessible without any difficulty. The longer you take to locate the first aid kit can make a huge difference in complicating the injuries.