Module three focuses on the prehospital diagnosis and management of shock and the effective use of teamwork and communication in high stress environments. We were lucky enough this month to be joined by Dr. Gareth Richards, who not only participated in the first two podcast for this module, but also provided us with an outstanding complement of critical care shock literature. The ARHT educational team would like to say a big thank you to Gareth for his help and commitment to our continued learning. We would also like to thank everyone who has helped out with this project to date.
Chapter one of this module is divided into two separate lectures. The first is a focused discussion on the diagnosis and basic management of shock in the prehospital environment. The second lecture uses a case based discussion to review the principals outlined in the first lecture. Chapter two of this module is all about trauma and will focus on the pre-hospital use of whole blood as well as the pre-hospital management of both blunt and penetrating cardiac arrest…. if the words pre-hospital thoracotomy don’t get you excited then you are reading the wrong blog!!!
Update: The educational team would like to extend a massive THANK YOU to Prof. Ian Civil, Dr. Mark Friedericksen, Dr. Tony Smith and our very own Dr. Chris Denny for joining us on our most recent trauma podcast. Bringing together experts from trauma services, the ICU, the emergency department and the pre-hospital setting produced (in our opinion) an outstanding discussion with multiple view points from all of those involved in the “chain of survival” following trauma. Only by working together from roadside to discharge can we improve the outcomes for our trauma patients.
Enjoy the podcast!
The simulations to be completed in this module are closely related to the content contained in these lectures.
Module #3 – Objectives
Module#3 – Chapter 1a – Shock-Teamwork and communication
Module #3 – Chapter 1b – Shock – Teamwork and Communication
Module #3 – Chapter 2a – Pre-hospital whole blood.
Module #3 – Chapter 2b – Damage Control Resuscitation
Module #3 – Chapter 2b – Traumatic Cardiac Arrest
Below you will find reference material to supplement the above lectures:
The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll.
Emerg Med Clin North Am. 2010 Feb;28(1):29-56
Focused assessment with sonography in trauma (FAST): should its role be reconsidered?
Postgrad Med J. 2010 May;86(1015):285-91.
Current role of emergency ultrasound of the chest.
Crit Care Med. 2011 Apr;39(4):839-45.
Lung ultrasound in the critically ill.
Ann Intensive Care. 2014 Jan 9;4(1):1.
Management of bleeding and coagulopathy following major trauma: an updated European guideline.
Crit Care. 2013 Apr 19;17(2):R76.
Bleeding and coagulopathies in critical care.
N Engl J Med. 2014 Feb 27;370(9):847-59.
N Engl J Med. 2013 Oct 31;369(18):1726-34.
N Engl J Med. 2013 Sep 26;369(13):1243-51.
Severe sepsis and septic shock.
N Engl J Med. 2013 Aug 29;369(9):840-51.
A randomized trial of protocol-based care for early septic shock.
N Engl J Med. 2014 May 1;370(18):1683-93.
Here you will find some excellent references regarding Pre-hospital thoracotomy:
Click to access A_12_Weaver.pdf
Click to access Thoracotomy.pdf
Click to access v022p00022.pdf
Click to access WTACriticalDecisionsResuscitativeThoracotomy.pdf