Fluid/Blood Resuscitation

ANES 521:  Principles of Anesthesia Practice I

        A 65 year old man presents to the operating room following a high-speed motor vehicle collision.  He was a passenger and the collision was near head-on on the driver’s side.  The driver did not survive.  The patient lost consciousness briefly after impact.  He bypasses the emergency room and comes straight to your operating room.  He is awake, alert, anxious and complaining of pain in his chest.  A quick assessment of the man reveals a large bruised area on his chest.  His abdomen is distended and he has a broken femur.  The general surgeon wants to do an exploratory laparotomy and the orthopedic surgeon will follow with an open reduction of his fractured femur.

 

The patient’s past medical history includes the following:

· Myocardial infarction 6 weeks ago

· Congestive heart failure     

· Hypertension

· Diabetes—non-insulin dependent

  

Objective data assessment is listed below:

Hemoglobin  -  6.0 mg/dl

Blood pressure - 160/100 mmHg

Pulse—130 bpm

Respirations— 32 breaths/min

 

         Working with a team of 5 classmates, devise and defend a fluid and blood resuscitation plan.

 

Task