Trauma 1 · 12 min · ground
ATS 2024 · 6 mL/kg · Pplat ≤30 · ΔP ≤14 · SpO₂ 92–96 · PaCO2 ~35–45
Load card puts the starting breath on the box. Connect starts the clock. End whenever you want.
41-year-old GSW right chest. Finger thoracostomy in the bay, poorly taped.
Tubed, one more hospital 12 minutes away. Starts okay. Then it doesn't.
Handoff
You are on PCV+. Peak looks 'fine.' The tell is VTE. If you miss the pneumo he will arrest in the ramp.
Recognize falling VTE as tension
Pressure-driven T1 will not gift you a high PIP.
Don't crank PEEP into a tension
That is how you finish the job.
Arrive with a pulse
Treat the chest, then the vent.
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