Navigation Links
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 IV fluids before transportation to a trauma center.

Haut and his associates found that on top of the 11 percent overall higher risk of death among such patients, some types of trauma patients faced an even worse prognosis when given a pre-hospital IV.

For example, patients whose injuries were due to a stabbing or shooting were found to face a 25 percent elevated risk of death if they were given a pre-hospital IV, relative to those who weren't. And those with severe head injuries and/or those who ultimately underwent emergency surgery in the hospital appeared to face a 35 percent greater risk of death if administered a pre-transport IV.

"I certainly don't think that this study is the final answer to the question about pre-hospital fluids," acknowledged Haut. "But I do think that we can see here that it's not always beneficial, and may actually be harmful."

Wally Ghurabi, emergency department director at the Santa Monica-UCLA Medical Center in Santa Monica, Calif., described the finding as "fascinating."

"On the one hand, this is really a question of plumbing, because you want to try and keep the patient's condition status quo until you get him in to the hospital. But if the patient has lost a liter of blood and you immediately water it down with an IV then you raise the patient's blood pressure, and that can change the patient's condition before you get him in," Ghurabi explained.

"So, then it all depends on the pre-hospital timing situation. Are you next door to a hospital or three hours away? Are you in New York City, one block away from NYU? That's one thing. But if you're in a rural area very far away, that's another. So there's potential here for some common sense to factor into the decision-making process," he added.

"And this study opens the door for us to talk about these issues," Ghurabi continued. "Right now, we have very specific pre-hospital criteria that we currently teach paramedics. And what we teach is to do the IV before taking the trauma patient in. But this study should get us to talk about that approach. And I think it should be open for discussion."

More information

For more on trauma care, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Elliott R. Haut, M.D., associate professor, department of surgery and department of anesthesiology & critical care, Johns Hopkins University School of Medicine, and director, Trauma/Acute Care Surgery Fellowship, Johns Hopkins Hospital, Baltimore; Wally Ghurabi, D.O., emergency department director, Santa Monica-UCLA Medical Center, Santa Monica, Calif.; February 2011, Annals of Surgery


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Red Cross Raises More Than $32 Million Via Mobile Giving Program
2. Want to Find Love? Be Giving
3. GNC Says Thank You to Customers and Employees for Their $1.4 Million in Donations to the Sixth Annual St. Jude Childrens Research Hospital(R) Thanks and Giving(R) Campaign
4. Tips for Safe Charitable Giving in Response to Earthquakes in Chile and Haiti
5. Women bear caregiving responsibility in cases of dependency in Spain
6. 'What Women Really Want In Bed' Is A Man's Guide To Giving Her The Sex She Wants
7. Crystal™ Responds to MIT Students Body Odor Problem By Giving Away All Natural Unscented Deodorant
8. Cat Allergy Doesnt Have to Mean Giving Up Kitty
9. Touching Souls International Giving Free Cataract Surgery and Eye Treatment in Bangladesh as Part of Ongoing Program June 6
10. Health Advocate, Inc. Hosts Free Caregiving: The Impact on the Workplace Webinar
11. Most Doctors Giving Pap Test Too Often
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Giving IV Fluids on Scene Might Raise Death Risk for Trauma Victims
(Date:2/14/2016)... (PRWEB) , ... February 14, 2016 , ... ... themselves without trained eating disorders professionals near their residence. The nature of the ... no transportation, child care or time allotted at work to make traditional appointments. ...
(Date:2/13/2016)... ... ... Cypress in Sun City is the place to be on March 3rd to learn about ... will be hosting this educational seminar from 5:30 p.m. – 7:00 p.m. Exciting advancements will ... offers. In addition, prizes will be given away and light refreshments will be served. ...
(Date:2/13/2016)... , ... February 13, 2016 , ... Many individuals looking ... protein for a multitude of reasons. IsoPasta by Isolator Fitness has delved into ... once more, but without the high-carb repercussions. IsoPasta has 30 grams of protein ...
(Date:2/13/2016)... ... February 13, 2016 , ... ... (INS) states that vein visualization technology should be used to ensure patient safety ... the world, the INS Standards mandate the use of vein visualization technology in ...
(Date:2/13/2016)... ... February 13, 2016 , ... In the early or “honeymoon” stage ... to perfection, go out of their way to be romantic, and may exaggerate a ... look at any online dating profile. , A recent study from Queendom.com ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... --  HeartWare International, Inc . (NASDAQ: HTWR ) ... its financial results for the three and 12 months ... at 8:00 a.m. ET.  The company plans to release ... webcast.  On the conference call and webcast, management will ... quarter and business outlook.   --> ...
(Date:2/12/2016)... , Feb. 12, 2016  Sequent Medical, Inc. ... a study to evaluate the safety and effectiveness of ... treatment of ruptured intracranial aneurysms.  Prof Laurent Spelle ... in Paris, France and Principal ... France and Germany.  Although ...
(Date:2/12/2016)... 2016  Aralez Pharmaceuticals Inc. (Nasdaq: ARLZ ) ... will ring the Nasdaq Closing Bell at the Nasdaq ... at 4:00 p.m. ET on Tuesday, February 16, ... Adrian Adams , will perform the honorary bell ... p.m. ET.  A live webcast will be available at: ...
Breaking Medicine Technology: