1. Trauma IV resuscitation:
-Need at least 16-18 gauge IV, order of preference for IV access sites: Large bore antecubital/peripheral > subclavian/fem/IJ > IO > venous cut down
-Fluids: if need to replenish <30% of total body water resuscitation use crystalloid, 30-40% add colloid to crystalloid to prevent fluid overloading, >40% add blood to prevent diluting out RBCs, platelets, coags
-Goals: SBP>80-100, hct 25-30
2. Trauma surgery anesthesia:
-Use general with ET tube because it's fast on, can be held for as long as necessary, and you can ventilate them; disadvantages are that it can worsen hypovolemia by decreasing vascular tone, you need to be able to get a tube in, and you can't do a neuro exam.
3. TBI: 
-GCS <8, severe TBI, 33-55% mortality
-GCS 9-12 moderate TBI, GCS 13-15 mild TBI, 2-3% mortality
-LOC is the hallmark of TBI
-Get to CT ASAP to r/o bleed.
4. ICP management, general principles: 
-Avoid hypoxemia, since that will lead to cerebral vessel dilation and worsening of ICP. Intubate early, use PEEP early.
-Keep the head elevated relative to body
-Control pain, even in obtunded patients; the ICP will rise to pain even in these people.
-Control temperature, as hyperthermia will increase CMRO2
5. Hyperventilation will reduce ICP and brain edema by leading to cerebral vasoconstriction. However, over time this will lead to ischemia, with elevating lactate and glutamate levels. So do this, but only for short periods of time, and only if you think there is a risk of herniation. Goal is pCO2 of 25-30
6. Osmotic diuretics like mannitol and hypertonic saline (3%) will decrease ICP from diuresis. Do not use glucose as your osmotic agent, as it readily crosses BBB. Know that the brain will eventually adjust to these osmotic diuretics, and they will become less effective over time. Also, osmotic diuretics are only effective if the BBB is intact, otherwise they will just cross over and possibly cause worse complications.
7. Steroids have not been shown to reduce mortality in patients with ICP. 
8. Barbituates like hyperventilation will reduce cerebral perfusion and reduce ICP, however they will also cause systemic hypotension that require pressors, which then will negate the ICP-reduction effect of the barbituates.
9. For chest trauma, rule out pneumothorax before you initiate positive pressure ventilation lest you cause a pneumothorax. Ventilate with low tidal volumes (<6ml/kg ideal body weight) and low PEEP. Ues double lumen ET tube for lung resections.
10. For chest trauma, get in A-lines, central lines and large bore IVs above the diaphragm-- if there is trauma to the great vessels in the chest, femoral or lower extremity lines will do you no good.