by Carlo » Mon Mar 19, 2007 2:20 pm
Not exactly sure what they mean by a 'Trauma IV'. When I use an IV in a true level I or level II trauma situation it means I try to obtain a large bore needle IV (16 or 14ga angiocath needle) from two sites (usually large vein sites like AC's or external jugulars) and use blood tubing on the set up for at least one of those.
Normal field protocol is to use a crystalloid solution as the initial fluid of choice(.9 normal saline, or lactated ringers depending on where you work, we use .9). We do not carry blood in the field as we do not have the capacity to type match on the fly. The military does not carry some synthetic volume expanders so they can carry less fluid with them (oversimplification: we have a big truck, they walk & carry everything).
The idea behind two sites with large needles is to be able to provide significant amounts of replacement fluids for lost blood volume. In the field we typically shoot to maintain a blood pressure of 90 systolic. (This is a change from the old days where they used to say give lots of fluid regardless. Short answer to a complex process is too much fluid equals too much pressure which make you bleed out faster leaving you with veins full of "cool-aid" (ie: little blood, lost of .9) which sucks at doing what blood is supposed to do).
That's what happens before you get to the ED door.
The only other reasons I can think of off hand to use large bore 'Trauma IV's' is for volume replacement for severe burns or volume replacement for dehydration.
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