Extravasation right SMA Communited nasal bone # branches Laparotomy vs Interventional radiology Left humerus # Severe liver lacerations left lobe Parenchymal Haemorrhages in RUL & LUL Right L2 - L5 TP # Conservative vs operative treatment Peri - splenic Right SIJ disruption haematoma Left renal lacerations Extensive soft tissue injury (grade 2/3) Serial debridements vs watch & wait right thigh
Erythropoietin Parenteral Iron Stimulate Erythropoiesis Established in Used in chemotherapy treatment of anaemia induced anaemia often secondary to CKD in in conjunction with dialysed patients erythropoietins Inconclusive in anaemia following trauma Limit blood loss Limit blood loss -Medically -Surgically Isolated case studies in Jehovah s Witnesses unclear contibution of EPO
Meticulous Haemostasis Stimulate Erythropoiesis Tournique t Initial Laparotomy Use of Cell saver Limit blood loss Limit blood loss Cochrane review -Medically -Surgically reduce relative Early amputation risk by 38% 1x fasciotomy Through knee amputation Delayed surgery
Stimulate Erythropoiesis Limiting blood tests Daily blood loss of 60-75 mls Accounting for 30% transfusion Limit blood loss Limit blood loss requirement Limiting haemofiltration -Medically -Surgically Paediatric sampling reduces blood loss by 40% Limiting infusions
1st look Laparotomy 2 nd look Laparotomy AKA Through Knee Amputation CARDIAC ARREST
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