Abstract
Where less is more; a case based discussion on the damage control resuscitation, a fundamental concept in the current management of major trauma
Highlights
Systemic inflammatory response syndrome (SIRS) is a condition recognized recently
It showed a non functioning necrotic fragmented left kidney indicating total avulsion at the time of injury. As his general condition improved steadily he was mobilized slowly and discharged home after a total of 28 days in the hospital. This young man presented in Class III haemorrhagic shock, intraperitoneal contamination and multiple intra abdominal organ injury posed a major challenge to clinicians
Permissive hypotension with limited crystalloids and early use of blood and blood components all warmed to body temperature as well as administration of tranexamic acid probably minimized the derangement of coagulation system and bleeding
Summary
Inadequacies in resuscitation limited the survival of patient in the initial hours after major trauma until a relatively recent development changed the picture. Damage Control Resuscitation (DCR) was developed In order to prevent this 'dark' sequence by addressing its initiation during the immediate post-major trauma period. We discuss this novel and lifesaving concept using our experience in the successful management of a young man who sustained a major trauma. DCR is the principle concept employed in the resuscitation of major trauma. This procedure saves lives increasingly and has gained acceptance globally. Perfection should be the aim, emergency health care systems in developing countries like Sri Lanka must embrace this concept and practice it as much as feasible for the benefit of many injured
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