Tag Archives: trauma

GAT conference take home messages

Tips:
Give IM atropine with IM sux
In obese O2 consumption is significantly greater during SV rather than IPPV
Epidural blood patch recommend 20ml
Dural puncture: inject 20ml normal saline down intrathecal catheter
NSAIDs may affect  platelets and clot strength of EBP
In difficult airway consider nasendoscopy.
AFOI topicalise. Reduce secretions by suction catheter or Yanker (also tests topicalisation)
Legal position: Prudent doctor  -> prudent patient
Coding – appropriately – gets the organisation appropriate money
Quality measures – e.g. length of stay
How to add value ? Outcome or quality / cost
In a report, if used a guideline say so
Detail discussions with patients, including apologies
References to read/watch/review:
‘Perfect storm NHS funding’
Cardiac arrest in neurosurgery patients

Cliff Reid YouTube videos
DOLS
NICE guidelines on trauma
BATLS, ATACC course
Kirkpatrick model (for simulation)

Cerebral perfusion pressure thresholds in TBI

CPP target range: 50 – 70 mm Hg

Patients with intact pressure  auto-regulation tolerate higher target CPP

Based on:

Aggressive attempts to maintain CPP > 70 mm Hg risk pulmonary oedema, cardiac failure, ARDS (Level II evidence)

CPP < 50 mm Hg should be avoided (Level III evidence)

Brain Trauma Foundation Guidelines.

https://www.braintrauma.org/coma-guidelines/searchable-guidelines/