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Winter 2022 Journal (Vol 22 Ed 4)
$47,00 -
Comparison of Warming Capabilities Between Buddy Lite, enFlow, and Thermal Angel for US Army Medical Personnel in Austere Conditions: A Literature Review
$43,00 -
Improvised Management of Polycythemia Vera Using Whole Blood Transfusion Kits
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Incidence of Airway Interventions in the Setting of Serious Facial Trauma
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Hypertonic Saline for Severe Traumatic Brain Injury With Herniation: A Military Prehospital Case Report
Antonino N, Payne R, Gaddy M, DeSoucy ES, Rush SC, Michael R 22(3). 98 - 100 (Journal Article)
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.