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Evaluating New Resuscitation Protocols in Penetrating Trauma

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Evaluating New Fluid Resuscitation Protocols in Penetrating Trauma Victims
Caitlyn R. Beck
Cedar Crest College

Evaluating New Fluid Resuscitation Protocols in Penetrating Trauma Victims
Article Summary The field of trauma originated when divisions of military set out to war and needed medical resources for the critically injured soldiers who were traumatically wounded in battle. But many of the ideas and protocols developed by trauma doctors in the military made their way to civilian hospitals and trauma centers that deal with varying traumatic injuries of the general public. A form of trauma, described as penetrating trauma, is an injury that occurs when an outside object pierces the skin of the human body and enters into the body tissue, leaving an opening in the skin. Penetrating trauma can be caused by a wide variety of things, most commonly a knife, fired bullets, or other types of weapons.
Often, with this kind of injury, there is blood and fluid loss in the victim sustaining the injury. Current Advanced Trauma Life Support (ATLS) guidelines for patients requiring fluid resuscitation is to infuse 2 L of a crystalloid solution, such as normal saline or lactated Ringer’s solution, before the patient is transfused with blood products (Tapia, Suliburk, & Mattox, 2013, p. 3961). However, many new studies examining current ATLS protocols and fluid resuscitation protocols is finding that “improved ratios of blood components appear to result in improved mortality outcomes” (Tapia, Suliburk, & Mattox, 2013, p. 3965). These studies are finding that initial fluid resuscitation with Red Blood Cell’s (RBC’s), Fresh Frozen Plasma (FFP), and Platelets (Plts) in a 1:1:1 ratio is much more effective than with just a crystalloid substance. This form of fluid resuscitation, also known as Damage Control Resuscitation (DCR) is used with a new clinical idea that

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