Fluid/Blood Resuscitation

        A 22 year old patient with multiple gunshot wounds bypasses the emergency room and lands in your operating room.  He has 6 visible bullet wounds.  He is stable, awake and oriented. You are anesthetist in charge and must put the man to sleep. 

         One hour into the case, the blood pressure falls to 80/40.  You decrease the anesthetic and take another blood pressure. This time, it is 72/36.  What are the contributing factors to his sudden hypotension?  An easy guess is that he is in urgent need of volume resuscitation with crystalloid solution and blood.  This lesson will review how to determine the amount and types of fluids to use to replace NPO deficit, Blood loss, and insensible loss.

Introduction

ANES 521:  Principles of Anesthesia Practice I