SCCM Resource Library-Damage Control: Orthopedics

Video Transcription

Video Summary

The speaker, Deb Stein, is a surgical intensivist and trauma surgeon who discusses the concept of damage control orthopedics. Damage control orthopedics involves the initial stabilization and management of fractures in polytrauma patients, followed by subsequent definitive surgical interventions once the patient's physiology has improved. The speaker emphasizes the importance of understanding the principles behind damage control orthopedics and explains that fixing fractures not only improves functional outcomes, but also has systemic implications. The traditional approach of immobilizing fractures has been replaced by early total care, which has been shown to have better outcomes and lower costs. However, the speaker cautions that early total care may lead to an excessive inflammatory response in some patients, particularly those who are unstable or in extremis. Hence, the speaker advocates for a selective approach to damage control orthopedics based on patient criteria such as coagulopathy, physiological stability, and severity of injuries. The speaker also discusses specific damage control approaches for different types of fractures, such as pelvic fractures, femur fractures, spinal fractures, and upper extremity fractures. Finally, the speaker acknowledges the lack of consensus and ongoing debate regarding the optimal application of damage control orthopedics and highlights the importance of collaborative management involving intensivists and orthopedic surgeons to maximize patient outcomes.

Asset Subtitle

Trauma, Resuscitation, 2022

Asset Caption

Damage control in trauma has become a critical component of care in the trauma patient. Learning Objectives: -Summarize damage control techniques for the critical care management of the trauma patient -Relate how damage control is extended into the ICU resuscitation -Illustrate how to prepare the trauma patient in the middle of damage control to return to the OR

Meta Tag

Content Type Presentation

Knowledge Area Trauma

Knowledge Area Resuscitation

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Trauma

Tag Hemorrhage

Tag Resuscitation

Year 2022

Keywords

damage control orthopedics

fracture stabilization

polytrauma patients

early total care

selective approach

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