Scoop and run in your area

[leviathan]

As a response to the previous thread, I'm curious how each of your services manages trauma patients in regards to the degree of "stay and play" vs. scoop and run. When, if ever, do you start an IV? Do you practice 'permissive hypotension', and if so, at what pressure do you stop bolusing your patients? When is intubation performed? Do you currently give any special fluids like hypertonic saline, or artificial haemoglobin?

In my service, IVs for hypovolemic patients are only started en route, fluid is rapidly infused up to 90 mmHg with a rate of 360/hour for anyone who is >90, and we are currently undergoing research with hypertonic saline for the ROC study.

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[146233]

"Stay and play" is discouraged. We start IV's of NS once en route to the hospital, if possible. We'd also do rapid infusion to maintain an SBP of 90mmHg. Intubation, when indicated, is performed on scene. That said, we often favor effective BVM ventilation or a Combitube over ET's when it comes to load & go traumas.

There is currently no protocol or pilot program in my area (that I'm aware of) for permissive hypotension. There was, not long ago, a clinical trial for a blood substitute, but my agency wasn't a participant. I'll check into it and see what happened.

 

[TarHeelEMT]

We pretty much never start IVs on trauma patients on-scene. With medical patients, we almost always get the IV either on-scene or in the back of the truck before we start driving (the driver will come back and assist the medic).