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Permissive Hypotension for Trauma Below the Neck

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Permissive hypotension is the intentional under-resuscitation of a patient, where the goal is to maintain a blood pressure that is adequate, but in the lower than normal range. This is achieved by restricting the amount of fluid administered while the patient is still actively bleeding.

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Most potentially-preventable deaths following major trauma are caused by uncontrolled bleeding. Researchers have found that early, high-dose fluid resuscitation may cause trauma patients experiencing severe haemorrhage to suffer adverse effects such as dilutional coagulopathy or acceleration of the haemorrhage. Nickson (2019) describes permissive hypotension, also known as hypotensive resuscitation or low-volume resuscitation, as a controversial and uncommon method of fluid resuscitation that may result in more desirable patient outcomes.

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Ausmed’s editorial team is committed to providing high-quality, well-researched and reputable education to our users, free of any commercial bias or conflict of interest. All education produced by Ausmed is developed in consultation with healthcare professionals and undergoes a rigorous review process to ensure the relevancy of all healthcare information and updates to changes in practice. If you have identified an issue with the education offered by Ausmed or wish to submit feedback to Ausmed's editorial team, please email ausmed@ausmed.com.au with your concerns.
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326 reviews by Ausmed Learners
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VA
Victoria Allen
17 Apr 2022
Good
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MIkka Jelinek
21 Oct 2020
Brilliant refresher for those that work in emergency healthcare.
PS
Paul Strong
27 Oct 2020
Very relevant information to frontline paramedics as this is a critical emergency not seen every day. To allow controlled hypotension needs close observation to vital signs.
EB
Evan Baker
11 Nov 2021
The article was short and straight to the point. Relevant and referenced, I have complete confidence in what I was reading.
PG
Patricia Greenaway
03 Nov 2020
It is great to know alternatives in trauma and emergencies to be aware of what can occur in different scenarios of fluids and trauma.
GB
Glen Barrington
16 Nov 2020
excellent
SA
Sally Anstess
22 Oct 2020
Great little reminder for a known concept in the pre-hospital setting. Knowing why we do things rather than just doing what our guidelines say is important and why we are clinicians, this article specifies that some patients require different treatments and this is something we need to keep in mind when treating every patient
KK
Kristine kealy
23 Oct 2020
This was very imformative and will help nurses and Drs manage patients alot more effectively and give more of a chance for mortality
AC
Allison Chafer
19 Nov 2020
Very interesting read thank you.
MM
Mervyn McAllister
05 Nov 2020
Very interesting information
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