The manner in which clinicians have used to resuscitate hemorrhagic trauma patients has been a continuous repetitive cycle over time. The cycle has gone from “run the fluids wide open in the patient” to “less is more in the patient”. As more evidence-based practice (EBP) emerges, reasons for ‘less is more’ become acutely evident. Large fluid volume resuscitation is highly suspicious for the exacerbation of the lethal triad of trauma: hypothermia, acidosis, and coagulopathy, thereby increasing bleeding and mortality (Cotton et al., 2006). The increased risk of bleeding also worsens the complications associated with trauma resuscitation. This all creates a cascade of potential harmful effects to the patient including, but not limited to coagulopathy, pneumonia, acute respiratory distress syndrome (ARDS), acute renal failure (ARF), multi-system organ failure (MOF), sepsis, infection and in some cases, death. Each of these unwarranted complications has the potential to increase the length of hospital stay therefore increasing the overall cost of care to the patient. In a recent study by Scott, et al., trauma care costs are estimated at $163 billion per year (Scott et al., 2020). For clinicians who treat trauma patients, the objective should be to provide better, more up to date trauma resuscitation care which would lead to a reduction of complications for the patient and, in turn, a decrease in the cost of care for the patient. This project will optimistically help guide that practice.
Date of publication
MSN Capstone Project
Masters in Nursing
McGowan, Pamala D., "Resuscitation of Hypovolemic Trauma Patients: Controlled /Hypotensive Resuscitation vs. Conventional Resuscitation" (2022). MSN Capstone Projects. Paper 192.