Shiv Shanker Tripathi1, Swagat Mahapatra2, Suruchi Ambasta3, Anurag Agarwal4
BACKGROUND
Trauma is one of the leading causes of mortality worldwide. Haemorrhagic shock
is a major factor leading to preventable trauma deaths, and optimum management
of this condition significantly affects outcome. Fluid resuscitation measures in
trauma have been a topic of debate since decades and guidelines regarding this
have been continuously evolving. We conducted this study to evaluate common
practices and management strategies being adopted among different specialties
involved in trauma care.
METHODS
We used a web-based study tool and peer reviewed questionnaire was designed
regarding basic aspects of fluid resuscitation in trauma patients. Survey was
conducted amongst Indian doctors from various specialties involved in primary
care of trauma, and they completed the self-administered e-survey.
RESULTS
The responses of 1000 participants fulfilling the inclusion criteria were considered
for our observations. The results were analysed based on two major groups, the
medical specialty group (anaesthetists, critical care physicians, emergency
physicians) and the surgical specialty group (general surgeons, trauma surgeons
and orthopaedic surgeons). There was a varied response among the two groups
to every question in the survey.
CONCLUSIONS
Trauma deaths due to haemorrhagic shock could be mitigated if the right fluid in
optimal amount is used at the correct time. We found that the initial impromptu
response of the entire group of doctors was less than ideal in many of the basic
fluid resuscitation approaches in the respondent groups. It was also noted that
there were significant differences in opinion among the medical specialties and
surgical specialties concerning the various aspects of fluid management in trauma.
