Postoperative resuscitation

You have just completed a major damage control operation with significant blood loss and ongoing resuscitation. As the patient rolls through the ICU doors, you are asked to write orders for the nurses to begin the postoperative care phase. You may or may not have an "intensivist" available to help you. Having a clear vision and plan for performing and monitoring the postoperative resuscitation is critical to avoid the twin evils of under-resuscitation and over-resuscitation. In combat surgery this is particularly critical as you often have to hand the patient off to the nurses or another physician and return to the ER or OR. Having a general approach or "philosophy" to resuscitation that the nurses, surgeons, and other physicians agree with and understand can make this process much smoother and less confusing.