I have been posting on a essay topic that doesnt seem to be working out to well for me. If you can offer any help for this alternate essay topic just in case i have to change i would appreciate it soooo much.
Possible alternate topic:
Assuming that the material I am looking for, just cannot be found in depth and in time, I am prepared to do a second choice of topic. So this may be easier to find for those of you who seem to dig through news articles with ease.
There is a growing controversy in the use of large volumes of crystalloid fluid replacement for patients who have externally hemorrhaged (from crushing injuries or car accidents, etc). Fewer paramedics believe that larger volumes of fluid replacement to maintain the blood pressure and continue perfusion of the tissues (staving off shock) is effective in patient survival management. There are studies (where? I don't know, just what I've read) that indicate that minimal amounts of fluid replacement has better outcomes.
Ok, so why? Well, when you bleed out you don't have enough blood to pump around your body. This means you can't get O2 around to the cells and CO2 out. This leads to acidosis which in turn leads to cell death.
Massive amounts of cells die -> tissues die -> organs die -> you die. That's Shock.
So traditionally we stick someone who is stuck under a tractor (for example) with 2 large bore IV's of Ringer's Lactate (just think water) so that there is enough fluid to keep circulating the remaining blood cells around (mostly it is water from blood that is lost in shock). We then remove the tractor and book it to the big H. If we didn't, lifting the tractor would send all the blood to the whole body decreasing pressure and killing the patient from shock.
Problems from this are that as the blood clots to seal leaks, say in the pancreas, large volume flow bursts the clots open creating real problems again with internal bleeding. It also makes it difficult to keep enough red blood cells in the system if we add fluid that flushes it out. Or else we get to the hospital and the patient is pumped full of fluid and needs blood transfused in....well, they gotta drain the patient (sorta).
So giving blood products in addition to minimal crystalloid solutions would be the best solution in some cases, but not necessarily in others. Also, local protocols don't always allow us to give blood products. And there can be good reasons for that.
Now this brings me to my alternate essay topic. I need to investigate the controversy and examine alternate methods (ie: PASG = pneumatic anti-shock garment) and proposed solutions from previous studies and current statistics. I need stats, protocols, news reports, and most of all, studies performed.
Possible alternate topic:
Assuming that the material I am looking for, just cannot be found in depth and in time, I am prepared to do a second choice of topic. So this may be easier to find for those of you who seem to dig through news articles with ease.
There is a growing controversy in the use of large volumes of crystalloid fluid replacement for patients who have externally hemorrhaged (from crushing injuries or car accidents, etc). Fewer paramedics believe that larger volumes of fluid replacement to maintain the blood pressure and continue perfusion of the tissues (staving off shock) is effective in patient survival management. There are studies (where? I don't know, just what I've read) that indicate that minimal amounts of fluid replacement has better outcomes.
Ok, so why? Well, when you bleed out you don't have enough blood to pump around your body. This means you can't get O2 around to the cells and CO2 out. This leads to acidosis which in turn leads to cell death.
Massive amounts of cells die -> tissues die -> organs die -> you die. That's Shock.
So traditionally we stick someone who is stuck under a tractor (for example) with 2 large bore IV's of Ringer's Lactate (just think water) so that there is enough fluid to keep circulating the remaining blood cells around (mostly it is water from blood that is lost in shock). We then remove the tractor and book it to the big H. If we didn't, lifting the tractor would send all the blood to the whole body decreasing pressure and killing the patient from shock.
Problems from this are that as the blood clots to seal leaks, say in the pancreas, large volume flow bursts the clots open creating real problems again with internal bleeding. It also makes it difficult to keep enough red blood cells in the system if we add fluid that flushes it out. Or else we get to the hospital and the patient is pumped full of fluid and needs blood transfused in....well, they gotta drain the patient (sorta).
So giving blood products in addition to minimal crystalloid solutions would be the best solution in some cases, but not necessarily in others. Also, local protocols don't always allow us to give blood products. And there can be good reasons for that.
Now this brings me to my alternate essay topic. I need to investigate the controversy and examine alternate methods (ie: PASG = pneumatic anti-shock garment) and proposed solutions from previous studies and current statistics. I need stats, protocols, news reports, and most of all, studies performed.