episode 6: resuscitation of the bleeding patient - the rise of BATES
First the rise of Skywalker, now the rise of Bates.Pete is back to finish up with round 2 of the management of the bleeding pelvic patient.We recorded this prior to Covid-19 being on anyone's register and the biggest concerns were Brexit and Storm Dennis. Fortunately, Kash has always practiced social distancing from Pete just to be on the safe side.We talk about AO and what they do. Pete explains how AO were initially very platey and not very naily and how it developed. He then gives us his travelogue on Leeds.We discuss the 1st and 2nd line resuscitation of the bleeding pelvic patient and Kash even finds himself pushing for BATES (listen and it will all make sense) but will stick with BASTE out of spite.We get stuck into clotting, TEG and ROTEM. Pete then goes on to display a hidden v nerdy understanding of Star Wars canon and dismisses Kash's superficial knowledge of the subject in comparison with barely concealed disgust.Things get slightly high-brow as we discuss 2.5 electrolytes, before reverting to normal and Pete threatens Kash with a baseball bat (joking not joking).We discuss the decision-making process when deciding whether to take the patient to the angio suite for embolisation, or to the operating theatre for pelvic packing.We finish up with a chat about the beauty of pelvic binders and what elevates them above external fixators and C-Clamps.'What could possibly go wrong' we wondered at the time of recording and didn't consider that someone might eat a bat and set off a chain of events that we had never seen in our lifetimes...Chapter timings:00:00:00 intro00:01:02 preface00:01:48 one more thing00:02:15 orthohub live webinar00:02:57 AO00:05:50 Pete's guide to Leeds00:06:36 review of 1st line resuscitation of the bleeding pelvic patient00:07:23 our DNAR policy00:07:40 2nd phase resuscitation of the bleeding pelvic patient00:08:27 what is BASTE00:09:42 B is for blood00:10:19 clotting, TEG & ROTEM00:12:58 the pufferfish of death00:14:10 Pete lets slip his hidden supernerd00:15:08 A is for Acid-Base 00:15:24 don't drink a bottle of Hydrochloric Acid00:16:32 T is for temperature (S just doesn't fit here)00:17:52 E is for electrolytes00:18:33 Pete threatens to kill Kash (joking not joking)00:22:33 S is for Surgery! 00:23:46 decision making: angio vs pelvic packing00:28:57 why binders are (nearly always) better than pelvic ex-fixes00:31:12 what if embolisation doesn't work 00:32:00. Pete summarises 00:33:56 small talk00:34:19 how about coronavirus?