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Giving IV Fluids on Scene Might Raise Death Risk for Trauma Victims
Date:1/6/2011

By Alan Mozes
HealthDay Reporter

THURSDAY, Jan. 6 (HealthDay News) -- The longstanding practice of first giving severely wounded trauma patients intravenous (IV) fluids before bringing them to a trauma center may actually raise their risk of death, a new study suggests.

The finding flies in the face of common medical wisdom and mandated protocols in some states that require that IV fluids be given to trauma patients immediately if their blood pressure drops precipitously.

But a fresh analysis of data on nearly 777,000 trauma patients revealed that, overall, those who are given pre-hospital IV fluids are actually 11 percent more likely to die than those who aren't, not only because of transport delays but also in part because of the increased risk for bleeding that can accompany a fluid-induced increase in blood pressure.

"IV fluid administration to trauma patients pre-hospital is like one of those things that's been thought of as mainstay, and that got implemented before there was science that showed it was actually the best thing to do," said study author Dr. Elliott R. Haut, an associate professor in both the department of surgery and the department of anesthesiology & critical care at the Johns Hopkins University School of Medicine in Baltimore. "And now of course it's a standard of care. And it's very hard to buck the trend with respect to something that's been done for 25 years."

But, he added, "the general idea here is that although obviously everybody has the best of intentions it might be that not all of the procedures we do for injured people are beneficial."

Haut, who is also the director of the Trauma/Acute Care Surgery Fellowship at the Johns Hopkins Hospital, and his colleagues report the findings in the February issue of the Annals of Surgery.

Most of the patients in the analysis were male, white and under 40, the research team noted, and about half were administered I
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