Pete talks us through the definition of damage control resuscitation and the application of this concept to critically injured patients in the pre-hospital setting. The discussion ranges from the practicalities of delivery to novel therapies sitting on the horizon.
Top 3 tips:
- Remember that the classic ABC algorithm has morphed into CABC and that C stands for the control of catastrophic haemorrhage. This has to be immediate and concurrent with managing the airway, breathing and circulation.
- Nail your IV lines! If a red team is on the way but you are on scene, you may be the one who has the best chance to place the IV cannula which is going to facilitate further resuscitation. Place it and make sure it is really secure.
- You can extend the classic algorithm from "ABCDE" to "CABCDEF" where “F” stands for forward planning. So immediately you are activated and en-route, start planning ahead and consider what other services you may need. If on scene you recognise a severe derangement in physiology activate the red or HEMS team as appropriate; the earlier these teams and the receiving facility receive patient information - the better they are able to allocate their resources.
Pete qualified in medicine in 1987 and has served in the UK Defence Medical Services ever since, apart from a nine-year sabbatical in New Zealand during which time he trained in helped to produce three children, trained in Emergency Medicine and explored the Southern Alps. He is a Consultant in Emergency Medicine and Retrieval Medicine, working between the Queen Elizabeth University Hospital in Glasgow and the Emergency Medical Retrieval Service (a component of the Scottish Specialist Transfer And Retrieval Service - ScotSTAR) when not deployed on Regimental duties. A climber and skier since his teenage years, these sports have taken him on adventures throughout the world and continue to foster his passion for Wilderness Medicine.