Fluid Therapy
It is widely recognised that pre-hospital
fluid therapy is contentious in the trauma setting. Research is ongoing
and should continue as to it's value in other settings.
Recent research suggests that Paramedics
may be under and over infusing in traumatic situations so who do we
listen to. The answer: Everybody, Services should be getting together
and gaining as much advice about this subject as possible. The more evidence we have - the better we can train to save
lives.
Some suggest that moderate
rather than aggressive fluid therapy in haemorrhagic injuries reduces
morbidity and that aggressive fluid therapy
can exacerbate uncontrolled haemorrhage and increase patient mortality. What do you think?
 On
the Road
You will find that most infusions you set up will be pretty straight
forward. Most accidents are in the home and during the day. It makes
sense doesn't it. Everybody's up and doing things!. When it becomes
difficult you may benefit from this advice. Keep warm fluids in the
vehicle somewhere. If you live in a cold place you'll need it one day.
Make sure your partner can run through a line without getting air emboli
in there. Hang up fluids on anything clean while you are working, don't
get your partner to hold it. He's much more valuable doing other things.
Doors, chairs, handles or tape the bag with heavy tape to anything
around.
 Use
the housing at the back of the flow control valve to hold the distal end
of the tubing while you are busy doing other things. Like cannulating
the patient! It keeps the end from flopping around on the ground
un-noticed.
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