In this episode we chat with Alex Smithers, trauma pharmacist, about the importance of calcium in trauma care.

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James reads an awesome poem to Rob, and then they talk about permissive hypotension in trauma resuscitations. What is the ideal MAP or SBP in hemorrhagic shock? what about with a head injury? What if your patient old? What if you have no blood products?

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Rob and James chat about the uselessness of a DRE in trauma resuscitation. They cover a recent systematic review on the test characteristics of the DRE and make a strong plea to providers to abandon this invasive, unnecessary test.

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James and Rob cover a paper on DSI vs RSI in trauma patients. Essentially, does giving ketamine to dissociate patients for preoxygenation of 3 minutes prior to paralytic improve incidence of peri-intubation hypoxia and other adverse events.

Take home - ketamine in this population is typically hemodynamically neutral and maintains spontaneous breathing. Its use in trauma airway management can facilitate not only adequate preoxygenation, but also patient assessment, and other resuscitative measures before intubation.

For more FOAM trauma related content head to www.trauma-ing.com

James and Rob cover audience questions including prebreifing your trauma team, decompressing chests, and all the subtle details of a massive hemorrhage protocol.

Stay tuned for more trauma related FOAM at our website www.trauma-ing.com or listen wherever you get your podcasts!