ICU Vivas · Trauma & burns
Data viva — a trauma resuscitation dataset
A data viva on the bloods of a bleeding trauma patient: acute traumatic coagulopathy, acidosis and hypocalcaemia thresholds, fibrinogen and platelet targets, and tranexamic acid timing.
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Target exams
CICMFFICMEDIC
Prompt
Arrival bloods from a bleeding trauma patient 50 minutes after injury.
Stimulus
You are shown blood results from a bleeding trauma patient on arrival, 50 minutes after injury:[1]
| Variable | Arrival |
|---|---|
| pH | 7.08 |
| Base excess (mmol/L) | −13 |
| Ionised calcium (mmol/L) | 0.85 |
| Clauss fibrinogen (g/L) | 1.3 |
| Platelets (×10⁹/L) | 85 |
Interpret the results and outline your priorities.[2]
References4ShowHide
- [1]Brohi K, Singh J, Heron M, et al. Acute traumatic coagulopathy. The Journal of trauma, 2003.PMID 12813333
- [2]Lier H, Krep H, Schroeder S, et al. Preconditions of hemostasis in trauma: a review. The influence of acidosis, hypocalcemia, anemia, and hypothermia on functional hemostasis in trauma. The Journal of trauma, 2008.PMID 18849817
- [3]Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Critical care (London, England), 2019.PMID 30917843
- [4]CRASH-2 collaborators, Roberts I, Shakur H, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet (London, England), 2011.PMID 21439633