Severe Trauma with Karim Brohi

By George Lim, MD

Please refer to EMCrit

PERMISSIVE HYPOTENSION

-       For Dr. Brohi, permissive hypotension is more of a mindset more so than goal BP’s

  • If he had to give number, SBP < 60 or 70 then provide crystalloid/blood products

-       Do NOT shoot for normal MAP’s in trauma resuscitations

-       In terms of blood pressure, Dr. Brohi does not treat head injury patients any different from other patients

 

TRAUMATIC ARREST

-       In a patient in traumatic arrest, there is NO role for closed chest CPR

  • Either call the code or open the chest

-       In a traumatic arrest, Dr. Brohi does NOT recommend vasopressors

MASSIVE TRANSFUSION

-       At Dr. Brohi’s shop, massive transfusion protocol instituted for

  • (1) SBP < 80 and not responding to small fluid boluses
  • (2) clinical suspicion of hemorrhagic shock

 

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