Tranexamic Acid In Trauma Paper

Dugdale, D. (2012, June 22). Cardiogenic Shock. U.S National Library of Medicine. Retrieved November 23, 2013, from http://www.nlm.nih.gov/medlineplus/ency/article/000185.htm

Trauma patients often present paramedics with difficult situations to handle. These patients most likely have multiple injuries that the paramedic must treat including internal and external injuries. The main concern in treating trauma patients is controlling the pain that the patient may be experiencing while not compromising the patients hemodynamic and respiratory state. The most common drugs used in pain management in the pre-hospital setting often cause undesirable side effects, such as respiratory depression, hypotension, apnea, and bradycardia. All of these side effects combined with a trauma patient who is already compromised can lead to a much bigger issue. What if there was a drug that could treat the pain, calm the patient, and not cause the nasty side effects of traditional pain management? Ketamine provides us the answer to this question.

Furthermore, prompt infusion of antimicrobial agents ought to be priority and this may require extra vascular access ports (Dellinger, et al., 2008). Early goal-directed resuscitation has confirmed to improved survival for emergency department patients presenting with septic shock in a randomized, controlled, single-center study. Resuscitation lessen 28-day death rate (Dellinger, et al., 2008). In a reviewed conducted by Dellinger, et al., (2012) advocated administering one litre of crystalloid or 300-500ml of colloid more than 30 minutes, to accomplish a central venous pressure (CVP) of 8 mm Hg to 12 mm Hg. Volumes ought to be increased if there are huge indications of hypoperfusion (Dellinger, 2014).

Professor Leslie Matthews of Morehouse School of Medicine is a trauma surgeon who treats TBI patients. He and his colleagues have just published a case series of a new successful treatment of TBI.

Sepsis and the lasting physiological effects of survivors are major concerns for the Center for Medicare/Medicaid Services (CMS),

XSTAT 30 was designed to be put in places where a tourniquet could not go and last up to four hours. Between 2001 and 2011 there was statistically nineteen percent of combat fatalities who died from blood loss. Some of these deaths could have been prevented because they were hit in places where the XSTAT could have controlled the hemorrhaging. The way that XSTAT was intended for was temporarily use for up to four hours so that the patient had enough time to receive surgery. The online website called “RevMedX” explains what XSTAT purpose is for. “RevMedX” expresses, “XSTAT works by injecting a group of small, rapidly-expanding sponges into a wound cavity using a syringe-like applicator. Each sponge contains an X-ray detectable marker. In the wound, the XSTAT sponges expand and swell to fill the wound cavity within 20 seconds of contact with blood. This creates a temporary barrier to blood flow and provides hemostatic pressure” (Xstat).  As stated, the XSTAT has “X-ray detectable markers” inside, which these will help the Surgeon who is working on a patient confirm complete surgical removal (RevMedX, Xstat). Another unique aspect of this medical device is that inside XSTAT is something called “chitosan.” Chitosan is a medical feature that is also put into Band-Aids to reduce bleeding as an antibacterial agent. In 2015, the Food and Drug Administration approved XSTAT to be used by civilians. “The FDA cited research by the US Army showing that 30% to 40% of civilian deaths from traumatic injury result from hemorrhaging, often before the patient reaches the hospital” stated from Robert Lowes on

Traumatic Brain injury, or TBI, is a common, yet extremely dangerous, type of injury. “In 2010, about 2.5 million emergency department (ED) visits, hospitalizations, or deaths were associated with TBI—either alone or in combination with other injuries—in the United States” (CDC). Traumatic Brain injury is usually defined as a violent shaking that occurs within the brain and it often occurs when there is a direct hit to the head or body. TBI “can affect motor, sensory, cognitive, and behavioral functioning” (AOTA), making daily tasks challenging or ultimately somewhat impossible. TBI’s are commonly classified by severity of the injury; mild being “a brief change in mental status or consciousness” and severe meaning

All over the world, with every new war breaking out, new medical innovations came with it. With each fatal injury incurred on soldiers it was up to surgeons to come up with effective solutions. According to most experts at the time of WW11 stopping the bleeding was in quote "the most vital step" to buy time for the soldier to recuperate and survive, better limb amputation methods led to significantly decreased deaths because of shock or bleeding out. Even today, in specific times in particular during the Afghan war, American medics brought into life new clotting agents that gave the injured more time to get full treatment at a hospital. Another tool that at first was frowned upon by medics

Injuries associated with TBI are divided into two categories: primary injuries and secondary injuries. Primary injuries are the direct physical damage incurred at the moment the trauma occurs. Secondary brain injuries occur indirectly as a result of trauma and usually appear hours or days after the initial injury. Secondary injuries exist as result of or separate from the initial injury. They cause complications such as hemorrhaging, alterations in intracranial pressure (ICP), and neurological deficits. Deterioration can occur even after patients have been downgraded from critical status. Approximately 40% of all cases of TBI deteriorate after hospitalization. These complications are a major cause of death in people with a TBI (Narayan et al., 2002). The brain normally maintains a state of homeostasis, meaning the cerebral perfusion pressure (CPP) stays within a normal range to adequately carry blood to the brain. The protective

Intensive brain injury, whatever its cause, is related with significant short-term and long-term morbidity and Mortality. Recently, stroke has been categorized as a medical emergency and several clinical trials have been done to find effectual therapies. A variety of insults can make worse the initial traumatic brainninjury and preventing or minimizing such insults represents a form of brain protection. Neuroprotective agents that can limit secondary tissue loss or recover behavioral results have been recognized in multiple animal models of acute brain injury.

Studies were identified by searching the Cochrane database, MEDLINE, EMBASE, Google scholar and bibliographies of relevant published articles. The primary outcome measures were the number of allogeneic blood transfusion exposures, the units transfused per patient, the postoperative haemoglobin and the mean drop in haemoglobin levels.

The human body is such an amazing structure that it is able to cope with trauma and destruction at extraordinary levels. We have become immune to hearing about the survivals of horrific falls, terrifying crashes and those who have survived accidents which are life threatening. Although, the survivors of these incidents rarely walk away unchanged, whether that be mentally or physically.

According to the Center for Disease Control and Injury Prevention, from ages three to thirty-four years, unintentional injury is the leading cause of death followed by suicide and homicide. The leading causes of death following an injury includes brain injury and hemorrhages. Unfortunately, deaths by hemorrhages usually are potentially preventable. On the battlefield,

Nowadays, the number of Cranio-cerebral penetrating injuries (CPI) is exponentially increasing. In addition, a massive incidence of CPI is observed in the developing countries affected by civil armed conflicts. Furthermore, even though the incidence of penetrating brain injuries is far less prevalent than closed head trauma, however CPI shows a worst prognosis. In fact, the survival rate of penetrating head injuries is reported to range from 7 to 15%. In addition, most of the victims (90%) die at the site of injury or in the ambulance and about 50% of those who reach the hospital dies in the emergency room (Alvis-Miranda et al., 2015). Such statistics are revealing the harsh reality of CPI. This report analyse the modern ballistic, the current protocols used in treating CPI and the complications that might arise.

A transfusion reaction is the body’s systemic response to the administration of blood. Causes for transfusion reactions can include red cell incompatibility, allergic response due to leukocytes, platelets, plasma protein components of transfused blood, or the anticoagulant (potassium or citrate preservatives) used to store the blood, just to name a few. Symptoms, prevention, and treatment will be discussed for the following transfusion reactions: Transfusion Associated Circulatory Overload (TACO), Transfusion-Related Acute Long Injury (TRALI), Hemolytic Transfusion Reactions, Anaphylaxis and Allergic Transfusion Reactions, and Febrile Transfusion Reactions.