Bad Bleeds in the Brain and PelvisFull episode audio for MD edition243:12 min - 339 MB - M4AEM:RAP 2017 February Australian EditionAustralian17:35 min - 24 MB - MP3EM:RAP 2017 February Canadian EditionCanadian18:09 min - 25 MB - MP3EM:RAP 2017 February Spanish EditionEspañol81:17 min - 112 MB - MP3EM:RAP 2017 February German EditionDeutsche68:14 min - 78 MB - MP3EM:RAP 2017 February French EditionFrançais28:00 min - 39 MB - MP3EM:RAP 2017 February Board Review Answers191 KB - PDFEM:RAP 2017 February Board Review Questions184 KB - PDFEM:RAP 2017 February Separate MP3 Files323 MB - ZIPEM:RAP 2017 February Spanish Written Summary1 MB - PDFEM:RAP 2017 February Written Summary971 KB - PDF
Daniel J. C. - February 3, 2017 8:35 AM
Great summary. Wished we had more specific information on empiric initial volume and or blood product recommendation in obvious pelvic fractures. And hey how about the old MAST Trousers? Dead and buried?
Chris H., MD - February 3, 2017 8:57 AM
It might be coming in Part II -- but my pelvic fracture "test dose" is 2U PRBC, pelvic binder and TXA. If the patient remains unstable after this, one of two things is possible: a) This is an arterial bleed, and the patient needs angio/OR ASAP, or b) There is another hemodynamically significant injury present that hasn't been addressed yet. So if the patient remains HD unwell after that "test dose" I am doing two things: activating our massive transfusion protocol (if I haven't already) and mobilizing angio and/or OR resources.
MAST trousers are dead -- but wait another 5 years and they'll be back in vogue! Medicine just seems to work like that.