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Fluid Therapy

It is widely recognised that pre-hospital fluid therapy is contentious in the trauma setting. Research is ongoing and should continue as to it's value in other settings.

Recent research suggests that Paramedics may be under and over infusing in traumatic situations so who do we listen to? The answer: Everybody, ambulance services should be collaborating and gaining as much advice about this subject as possible. The more evidence we have - the better we can train our staff to save lives.

Some suggest that moderate rather than aggressive fluid therapy in haemorrhagic injuries reduces morbidity and that aggressive fluid therapy can exacerbate uncontrolled haemorrhage and increase patient mortality. What do you think?

On the Road
You will find that most infusions you set up will be pretty straight forward. Most accidents are in the home and during the day. It makes sense doesn't it. Everybody's up and doing things!. When it becomes difficult you may benefit from this advice. Keep warm fluids in the vehicle somewhere. If you live in a cold place you'll need it one day. Make sure your partner can run through a line without getting air emboli in there. Hang up fluids on anything clean while you are working, don't get your partner to hold it. He or she is much more valuable doing other things. Doors, chairs, handles will do, or tape the bag with heavy tape to anything available.

Use the housing at the back of the flow control valve to hold the distal end of the tubing while you are busy doing other things. Like cannulating the patient! It keeps the end from flopping around on the ground un-noticed.

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