1. Fluid Therapy in Emergency Care Dr. Rashidi Ahmad Medical Lecturer/emergentist School Of Medical Sciences USM Health Campus Kelantan 2 nd Regional Fluid Transfusion Workshop 10 February 2007
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3. “ The Neglected Disease of Modern Society” Trunkey, DD
4. Trauma Chain of survival Fluid therapy is a part of the factors…
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6. O2 flux = [ C.O X Hb X SaO2 X k] + [ C.O X PaO2 x 0.003] Principle of fluid therapy in Emergency care
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9. Marius Keel, Omar Trentz. Pathophysiology of polytrauma. Injury (2005) 36, 691 - 709
37. HES & allergic reactions Laxenaire MC et al. Anaphylactoid reactions to colloid plasma substitutes: incidence risk factors mechanisms. Annales Francais d’Anesthesie et Reanimation 1994;13:301–10 A French multicenter prospective study.
57. The optimal volume of IV fluid administered is a balance between improving tissue oxygen delivery against increasing the blood loss by raising SBP MODS CLOTS Major controversy
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72. Marx et al. Int Care Med , 2002 Fluid requirements
79. Prehospital care, Arrival to ED Stabilization of vital signs Relieve tissue hypoxia Admission in ICU Phase 1 Phase 2 Phase 3 End point of Resuscitation of Shock
80. RADY ET AL • RESUSCITATION IN THE ED. AMERICAN JOURNAL OF EMERGENCY MEDICINE • Volume 14, Number 2 • March 1996 . End point of Resuscitation of Shock
Tq 2 the organizing comitte 4 inviting me to deliver this topic. 4 me this topic is very relevant 4 us because trauma cases are common. RTA kills our youngsters. When it occurs it involves many victims – it leads to morbidity & mortality. Being as the common health problem and kills those productive people, yet nothing much has been done to improve the trauma management. If Donald Trunkey said trauma is the neglected disease of modern society, perhaps u can imagine how good we are managing the trauma cases. Prof. Donald trunkey is a trauma surgeon, working at oregon health science universiti, US. Is it true? Just simple questions, how many of u BTLS certified. How many of U ACLS certified? None. How about MTLS certified? BTC certified? Don’t ask whether I certified or not…