Dallas to test resuscitation techniques

[vs-eh?]

...but what device is used for increasing inner-thoracic pressure (vacuum) ?..

I saw the ITD at my last CME.

As I recall it is a fairly small piece of plastic that is attached to the end of the ETT. This adds to our already lengthy extension (filter, ETCO2, extender...). They can only be used in a closed system, though I think they can be attached to a "BVM-only" ventilation. With the BVM-only...you need to have 2 people one solely for maintaining a good (2-handed) seal, otherwise the ITD is useless.

Again, I believe we get this in the late summer, early fall.

[Ridryder 911]

Interesting, when I did a querry I found many researches that had been terminated using it, then NASA when it was invented, here is another one that goes into more patho-physio on the working of it in trauma pig studies. [web:5a7897909a]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15508668&dopt=Abstract[/web:5a7897909a]

[flight-lp]

"The first treatments to be tested will be highly concentrated forms of a saline solution similar to the body’s own fluids. Typically, in the crucial early minutes before blood transfusions can be safely administered in hospital, trauma patients receive normal saline solution intravenously in the field to compensate for blood loss and buy time. In the new trial, trauma patients with either signs of blood loss or severe brain injury will receive one of three saline solutions — standard normal saline, high concentration saline, or high concentration saline with dextran, a circulation-enhancing substance. The two concentrated solutions are designed to compensate for blood loss more effectively, lessen excessive inflammatory responses and prevent brain swelling. These effects in turn could potentially lead to a reduction in organ failure for patients with major blood loss and improved function for patients with brain injury."

Concentrate it all you want, it still doesn't carry oxygen, period! So you decrease some swelling, yea great, but your still not perfusing! "Before blood transfusions can be safely administered in hospital", what happened to using it in the field? Is there some magical force that prevents it? Bottom line, trauma patients die if they do not circulate oxygen plain and simple, NS on speed isn't going to change that!

"The implications of this thing are tremendous," said Dr. Paul Pepe, chief of emergency medicine at UT Southwestern. "We're a center of excellence, and that's why they chose us."

This coming from the man who said fluid in the field for trauma patients was bad! Dr. Pepe has yet to come up with a research project that doesn't flop! I agree with Rid, this is going to be interesting..................

[Asysin2leads]

Concentrated whosamawhatsit now? Okay, ummm, correct me if I'm wrong, but I always thought good old NS 0.9% was supposed to be akin in tonicity to the body's own fluids? What's all the jibberjabber about this new concentrated stuff being close to the body's own fluids?

Personally, I'd don't quite buy it. I like to go with the "if it ain't broke, don't fix it" school of prehospital care, or in the case of a trauma victim, its more like "if it's already real done broke, don't break it no more." Usually, the body knows what its doing. A body tries to compensate the best it can for blood loss, and I just don't see how screwing with the body's compensatory system by drawing off fluid from the interstitial space (what I guess they're trying to do with this stuff) is going to help someone who's already got a world of problems. Rapid infusion, which is already under sever scrutiny for its efficacy, is just volume expanding, you're not changing any homeostatic mechanism, more or less. Introducing concentrated saline into a body, I just can't see it having much benefit, and I can think of some real problems, I mean, unless somehow a hypertonic solution can pick up soem RBC's that happen to be laying around unused in an exsanguination victim, but I don't think it can.

The other one, with the whole active return of blood flow to the heart and lungs, that sounds better. But will it work the next time someone shoots JR?

[Asysin2leads]

Concentrated whosamawhatsit now? Okay, ummm, correct me if I'm wrong, but I always thought good old NS 0.9% was supposed to be akin in tonicity to the body's own fluids? What's all the jibberjabber about this new concentrated stuff being close to the body's own fluids?

Personally, I'd don't quite buy it. I like to go with the "if it ain't broke, don't fix it" school of prehospital care, or in the case of a trauma victim, its more like "if it's already real done broke, don't break it no more." Usually, the body knows what its doing. A body tries to compensate the best it can for blood loss, and I just don't see how screwing with the body's compensatory system by drawing off fluid from the interstitial space (what I guess they're trying to do with this stuff) is going to help someone who's already got a world of problems. Rapid infusion, which is already under sever scrutiny for its efficacy, is just volume expanding, you're not changing any homeostatic mechanism, more or less. Introducing concentrated saline into a body, I just can't see it having much benefit, and I can think of some real problems, I mean, unless somehow a hypertonic solution can pick up soem RBC's that happen to be laying around unused in an exsanguination victim, but I don't think it can.

The other one, with the whole active return of blood flow to the heart and lungs, that sounds better. But will it work the next time someone shoots JR?

[Asysin2leads]

Concentrated whosamawhatsit now? Okay, ummm, correct me if I'm wrong, but I always thought good old NS 0.9% was supposed to be akin in tonicity to the body's own fluids? What's all the jibberjabber about this new concentrated stuff being close to the body's own fluids?

Personally, I'd don't quite buy it. I like to go with the "if it ain't broke, don't fix it" school of prehospital care, or in the case of a trauma victim, its more like "if it's already real done broke, don't break it no more." Usually, the body knows what its doing. A body tries to compensate the best it can for blood loss, and I just don't see how screwing with the body's compensatory system by drawing off fluid from the interstitial space (what I guess they're trying to do with this stuff) is going to help someone who's already got a world of problems. Rapid infusion, which is already under sever scrutiny for its efficacy, is just volume expanding, you're not changing any homeostatic mechanism, more or less. Introducing concentrated saline into a body, I just can't see it having much benefit, and I can think of some real problems, I mean, unless somehow a hypertonic solution can pick up soem RBC's that happen to be laying around unused in an exsanguination victim, but I don't think it can.

The other one, with the whole active return of blood flow to the heart and lungs, that sounds better. But will it work the next time someone shoots JR?