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Hextend......it has a role but for penetrating trauma, blood wins or nothing; Red and yellow can save a fellow, clear can kill at will.
Giving blood and plasma wins the day. IV fluid dilutes the remaining blood, dilutes the coagulation factors that remain and temporarily increases blood pressure which can pop a clot right off its stable position and doesn't hang out long at all.
Give one liter of saline and in 30 minutes only 300mL is intravascular. Which is why we try and preserve what's in the body the best we can.
Hex tend will stay intravascular longer but has no oxygen carrying capability; treating a number to get BP up but to what end???
ss
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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