In this episode Andrew Perry interviews Bruce Paix, a very experienced pre-hospital/retrieval (and military) Anaesthetist and trauma expert about haemorrhage control in trauma.
This is a great episode with some real pearls. Bruce challenges the traditional teaching in trauma by asking us to not be afraid of the hypotensive trauma patient, but rather to accept it as part of our adaptive response to controlling our own bleeding and rather than calling it “permissive hypotension” he introduces the concept of “therapeutic hypotension”. He also emphasises that the volume or choice of fluid in trauma is far less important than stopping the bleeding. Other topics covered include the utility of end-tidal carbon dioxide monitoring as a marker of cardiac output, there’s a brief discussion of tourniquets (with more on this topic coming soon) and more!
Shout out to SAAS MedSTAR (the South Australian Pre-hospital and Retrieval Service) for granting permission for us to use this interview. Thanks!