Detection and Management of Non-Compressible Hemorrhage by Vena Cava Ultrasonography
Jay Doucet, MD

This is a study of patients admitted with major traumatic injuries admitted in shock, otherwise known as low blood pressure. Such patients may develop inadequate circulation to the organs as a result of internal blood loss. Early detection of internal blood loss can be difficult as physical examination alone may not detect significant internal blood loss. After traumatic injury, some patients with bleeding will develop shock.

The inferior vena cava is the large vein draining blood from the lower body to the heart. The inferior vena cava stores blood and is known to empty when the patient has had significant blood loss. The vena cava diameter can be seen using ultrasound. This study intends to perform ultrasound to examine the vena cava diameter on patients just after arriving at a Trauma Center with major trauma and shock before and after giving fluids.

The study proposes that measuring the inferior vena cava in this manner can predict those patients who are likely to continue bleeding and require interventions such as surgery. Early detection in these patients may avoid delays in treatment, complications and excess mortality. Because this examination is done with handheld ultrasound machines, it could be done outside hospitals and in military combat casualty care.