[Emergency Trauma Room Management in Severely and Most Severely Injured Patients. A Multidisciplinary Task]

Overview

Journal Med Klin Intensivmed Notfmed

Specialties Critical Care
General Medicine

Date 2012 Apr 25

PMID 22526063

Citations 4

Authors

B Hussmann

C Waydhas

S Lendemans

Affiliations

Soon will be listed here.

Abstract

The treatment of most severely injured patients represents a great challenge for the trauma room team. Besides the time factor, which is a crucial cornerstone of the treatment in general and of the appropriate treatment of life-threatening injuries in particular, minor injuries and non-life-threatening injuries must also be taken into account. For this task, multidisciplinary processes play a paramount role. Advanced Trauma Life Support®, Definitive Surgical Trauma Care and the European Trauma Course represent training concepts, which predefine structured diagnostic and treatment procedures. These concepts allocate the highest treatment priority to injuries that may be immediately fatal for the patient. Besides those life-threatening injuries that are commonly summarised under the term "deathly six", other minor traumas should also be assessed and treated in a structured manner as they may often considerably affect the quality of life after trauma.

Citing Articles

Physician-based on-scene airway management in severely injured patients and in-hospital consequences: is the misplaced intubation an underestimated danger in trauma management?.

Ozkurtul O, Struck M, Fakler J, Bernhard M, Seinen S, Wrigge H Trauma Surg Acute Care Open. 2019; 4(1):e000271.

PMID: 30899797 PMC: 6407536. DOI: 10.1136/tsaco-2018-000271.

The dead and the dying - a difficult part of EMS transport: A Swiss cross-sectional study.

Hasler R, Stucky S, Bahler H, Exadaktylos A, Neff F PLoS One. 2018; 13(2):e0191879.

PMID: 29485991 PMC: 5828436. DOI: 10.1371/journal.pone.0191879.

[Implementation of a new emergency room protocol at a University Medical Center in Germany: basis for improved flow of information, adequate quality management and scientific assessment].

Ross D, Hinz J, Mansur A, Mielck F, Roessler M, Quintel M Anaesthesist. 2015; 64(3):208-17.

PMID: 25782779 DOI: 10.1007/s00101-015-0011-0.

[Fractures of the lower extremity in the emergency room. Analysis of a new immobilization and x-ray splint].

Kraus T, Kirchhoff C, Martetschlager F, Braun K, Siebenlist S, Ganslmeier A Med Klin Intensivmed Notfmed. 2013; 108(2):139-43.

PMID: 23467759 DOI: 10.1007/s00063-013-0225-3.

References

Wanek S, Mayberry J . Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury. Crit Care Clin. 2004; 20(1):71-81. DOI: 10.1016/s0749-0704(03)00098-8. View

Bouillon B . [Do we really not need a "trauma leader" in the emergency room?]. Unfallchirurg. 2009; 112(4):400-1. DOI: 10.1007/s00113-008-1547-0. View

Roberts I, Shakur H, Afolabi A, Brohi K, Coats T, Dewan Y . The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011; 377(9771):1096-101, 1101.e1-2. DOI: 10.1016/S0140-6736(11)60278-X. View

Nast-Kolb D, Trupka A, Ruchholtz S, Schweiberer L . [Abdominal trauma]. Unfallchirurg. 1998; 101(2):82-91. DOI: 10.1007/s001130050239. View

Pehle B, Nast-Kolb D, Oberbeck R, Waydhas C, Ruchholtz S . [Significance of physical examination and radiography of the pelvis during treatment in the shock emergency room]. Unfallchirurg. 2003; 106(8):642-8. DOI: 10.1007/s00113-003-0629-2. View

Cohn S, Lyle W, Linden C, Lancey R . Exclusion of cervical spine injury: a prospective study. J Trauma. 1991; 31(4):570-4. DOI: 10.1097/00005373-199104000-00018. View

Pal J, Victorino G . Defining the role of computed tomography in blunt abdominal trauma: use in the hemodynamically stable patient with a depressed level of consciousness. Arch Surg. 2002; 137(9):1029-32; discussion 1032-3. DOI: 10.1001/archsurg.137.9.1029. View

Lendemans S, Kreuzfelder E, Waydhas C, Nast-Kolb D, Flohe S . [Clinical course and prognostic significance of immunological and functional parameters after severe trauma]. Unfallchirurg. 2004; 107(3):203-10. DOI: 10.1007/s00113-004-0729-7. View

Dyer D, Moore E, Mestek M, Bernstein S, Ikle D, Durham J . Can chest CT be used to exclude aortic injury?. Radiology. 1999; 213(1):195-202. DOI: 10.1148/radiology.213.1.r99oc49195. View

10.

DeAngelis N, Wixted J, Drew J, Eskander M, Eskander J, French B . Use of the trauma pelvic orthotic device (T-POD) for provisional stabilisation of anterior-posterior compression type pelvic fractures: a cadaveric study. Injury. 2008; 39(8):903-6. DOI: 10.1016/j.injury.2007.12.008. View

11.

HARLEY J, Mack L, Winquist R . CT of acetabular fractures: comparison with conventional radiography. AJR Am J Roentgenol. 1982; 138(3):413-7. DOI: 10.2214/ajr.138.3.413. View

12.

Matthes G, Stengel D, Seifert J, Rademacher G, Mutze S, Ekkernkamp A . Blunt liver injuries in polytrauma: results from a cohort study with the regular use of whole-body helical computed tomography. World J Surg. 2003; 27(10):1124-30. DOI: 10.1007/s00268-003-6981-0. View

13.

Ruchholtz S, Waydhas C, Schroeder T, Piepenbrink K, Kuhl H, Nast-Kolb D . [The value of computed tomography in the early treatment of seriously injured patients]. Chirurg. 2002; 73(10):1005-12. DOI: 10.1007/s00104-002-0429-1. View

14.

Boyd M, Vanek V, Bourguet C . Emergency room resuscitative thoracotomy: when is it indicated?. J Trauma. 1992; 33(5):714-21. View

15.

Kish G, Kozloff L, JOSEPH W, ADKINS P . Indications for early thoracotomy in the management of chest trauma. Ann Thorac Surg. 1976; 22(1):23-8. DOI: 10.1016/s0003-4975(10)63946-x. View

16.

Hess J, Brohi K, Dutton R, Hauser C, Holcomb J, Kluger Y . The coagulopathy of trauma: a review of mechanisms. J Trauma. 2008; 65(4):748-54. DOI: 10.1097/TA.0b013e3181877a9c. View

17.

Lendemans S, Heuer M, Nast-Kolb D, Kuhne C, Dammann M, Lefering R . [Significance of liver trauma for the incidence of sepsis, multiple organ failure and lethality of severely injured patients. An organ-specific evaluation of 24,771 patients from the trauma register of the DGU]. Unfallchirurg. 2008; 111(4):232-9. DOI: 10.1007/s00113-008-1409-9. View

18.

Kuhne C, Mand C, Lefering R, Lendemans S, Ruchholtz S . [Urgency of neurosurgical interventions for severe traumatic brain injury]. Unfallchirurg. 2011; 116(1):39-46. DOI: 10.1007/s00113-011-2042-6. View

19.

Westhoff J, Laurer H, Wutzler S, Wyen H, Mack M, Maier B . [Interventional emergency embolization for severe pelvic ring fractures with arterial bleeding. Integration into the early clinical treatment algorithm]. Unfallchirurg. 2008; 111(10):821-8. DOI: 10.1007/s00113-008-1479-8. View

20.

Hussmann B, Taeger G, Lefering R, Waydhas C, Nast-Kolb D, Ruchholtz S . [Lethality and outcome in multiple injured patients after severe abdominal and pelvic trauma. Influence of preclinical volume replacement - an analysis of 604 patients from the trauma registry of the DGU]. Unfallchirurg. 2010; 114(8):705-12. DOI: 10.1007/s00113-010-1842-4. View