Ten Organizational Design Models to align structure and operations to busines...
Fluid and blood resuscitation in abdominal trauma
1. “ FLUID AND BLOOD RESUSCITATION IN ABDOMINAL TRAUMA: IMPORTANT TIPS IN CLINICAL PRACTICE FOR SURGEONS ” Dr. T.C. Kriplani Professor & Head Department of Anaesthesiology NSCB Medical College JABALPUR (M.P.)
2. American College of Surgeons Classes of Acute Hemorrhage Factors I II III IV Blood loss <15% (<750ml) 15-30% (750-1500ml) 30-40% (1500-2000ml) >40% (>2000ml) Pulse >100 >100 >120 >140 B.P. Normal Normal ↓ ↓↓ Pulse pressure N or ↓ ↓ ↓↓ ↓↓ Capillary refill <2s 2-3s 3-4s >5s Resp. rate 14-20 20-30 30-40 >40 Urine output ml/hr 30 or more 20-30 5-10 Negligible Mental status Slightly anxious Mildly anxious Anxious & confused Confused Lethargic
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15. Physiochemical properties of different H.E.S. preparations HES 70/.5 HES 130/.4 HES 200/.5 HES 200/.5 HES 450/.7 Concentration 6% 6% 6% 10% 10% Oncotic pressure mm. of Hg 30-36 36 30-37 55-60 25-30 Volume expansion 100% 100% 100% 130% 100% Half life (hrs) 1-2 2-3 3-4 3-4 5-6 Maximum dose ml/kg 33 50 33 33 20 Effect on hemostasis 0 Negligible + ++ +++