A 9-year-old male was involved in a serious motor vehicle crash as an unrestrained backseat passenger. EMS on the scene called in a trauma alert and he arrived at our emergency room combative, with missing teeth and blood in his airway. He also exhibited facial injuries upon initial examination. The patient’s vital signs demonstrated signs of shock with a heart rate of 140 and BP 87/46. Given his injuries he was intubated upon arrival.
A pan scan CT revealed a small left pneumothorax, pulmonary contusion, and a small splenic laceration. Given this patient’s condition I elected to send the patient to CT to assess traumatic brain injury (TBI), but due to hypotension we administered 10ml/kg (patient was 30 kg Handtevy weight) of saline by LifeFlow prior to CT. Rapid perfusion improvement with a LifeFlow fluid bolus allowed the patient to go to CT in stable condition. Following CT we administered a second bolus and transferred the patient to the PICU with a heart rate of 95 and a recovered BP of 124/72. As TBI was confirmed, the patient was discharged to rehabilitation. The left pneumothorax resolved prior to discharge.
In patients with traumatic brain injury, every minute of hypotension increases the risk of mortality.1,2 Early fluid resuscitation for immediate reversal of shock improves patient outcomes.3,4,5 Rapid patient stabilization can also buy minutes to allow for appropriate evaluation and diagnosis. In our experience LifeFlow can allow providers to administer a 500ml bolus in under 2 minutes, which reduces our team’s stress and allows us to more quickly move patients to the next phase of care. We were grateful in this case to have LifeFlow in our resuscitation toolbox.