Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Mar 2016
Review[Avalanche accidents and treatment of avalanche victims].
Avalanches may be provoked spontaneously or as a result of human activity, and they trigger the need for considerable rescue resources. Avalanche search and rescue operations are complex and characterised by physical and mental stress. The guidelines for resuscitation of avalanche victims may be perceived as complex and abstruse, which can lead to suboptimal treatment and an increased strain on rescue teams. The purpose of this article is to summarise the principles for medical treatment of avalanche victims.
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Blood products are a limited resource. A number of studies have shown that the use of thromboelastography (TEG) may reduce the need for blood transfusions. The analysis can be used in acute situations in patients with massive haemorrhage as a guide to transfusion therapy. Use of TEG may play an important role in targeting transfusion therapy.
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The management of benzodiazepine-resistant GHB withdrawal requires careful consideration of GHB pharmacodynamics. ⋯ GHB targets the GABAB receptor and downregulates it with abuse. Most anaesthetic agents affect the GABAA receptor. Our report suggests that baclofen, a GABAB receptor agonist, may reduce the need for anaesthetic agents and facilitate recovery.