医学
高渗盐水
创伤性脑损伤
重症监护医学
医疗急救
脑疝
麻醉
精神科
作者
Nicholas Antonino,Ryan Payne,Matthew Gaddy,Erik S DeSoucy,Stephen C Rush,Randy Michael
出处
期刊:Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
日期:2022-01-01
卷期号:22 (3): 98-98
摘要
Severe traumatic brain injury (sTBI) is a devastating injury with limited prehospital therapies available. The Joint Trauma System (JTS) Clinical Practice Guidelines recommend hypertonic saline (HTS) for casualties with sTBI and signs of impending or ongoing herniation (IOH), but its use by combat medics has never been reported in the literature. This report details the management of a pregnant patient with sTBI and signs of IOH, including the use of HTS, by US Air Force pararescumen in an austere prehospital setting. Treatment with HTS was followed by improvement in the patient's neurologic exam and successful evacuation to definitive care where her child was delivered alive. Additionally, we review the pathophysiology and signs of herniation, the mechanism of action of hyperosmotic therapies, and the rationale behind the use of HTS in the combat setting.
科研通智能强力驱动
Strongly Powered by AbleSci AI