Document Type : Original Article
1 Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
2 Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
3 Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Objective: The adherence of the physicians to guidelines in resuscitation of the patients
is of great importance since it can predict the outcome. To evaluate the adherence of the
physicians of our center in hydration of traumatic patients with crystalloids regarding the
Advanced Trauma Life Support (ATLS) guidelines.
Methods: We designed an algorithm obtained from ATLS guidelines using vital signs
and status of bleeding of the traumatic patients to classify them. After categorizing the
patients according to the algorithm, we evaluated the adherence of the physicians to the
guideline in hydration of traumatic patients with crystalloids.
Results: This is a cross-sectional study in which 998 traumatic patients who were admitted
to the emergency ward of Rajaee trauma hospital were enrolled. Most of the patients were
men (89.6%) and the most common causes of traumatic injuries were traffic accidents.
Proper hydration was seen in only 14.7% of the patients. Most of the patients were overhydrated (85%) regarding both our algorithm and the patients’ base excess.
Conclusion: The present study showed that the adherence of physicians in our center
in resuscitation with crystalloid was low. Also, most of the traumatic patients were
overhydrated with crystalloids. It is suggested that physicians retrain concerning the
side effects of over hydration. In addition, we need a user friendly and more applicable
guideline for hydration with crystalloids
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