[Prehospital Resuscitation of Patients with Multiple Injuries]

Overview

Journal Unfallchirurg

Date 2014 Jan 31

PMID 24477802

Citations 4

Authors

M Winkelmann

M Wilhelmi

Affiliations

Soon will be listed here.

Abstract

Introduction: Polytrauma is the leading cause of morbidity and mortality in young adults (aged 35-45 years). At 30-40%, traumatic hemorrhage is the most frequent preventable cause of death. Approximately every fourth patient with multiple injuries suffers from trauma-induced coagulopathy.

Methods: The current knowledge of prehospital resuscitation of patients with multiple injuries based on a selective literature research and experience in a level I trauma center are presented.

Results: Hemorrhagic shock is a clinical diagnosis and the recognition by the first responding emergency physician requires rapid evaluation of the accident situation, injury pattern and patient's hemodynamic status. In the future, tools will help to reliably estimate shock. Development of trauma-induced coagulopathy is multifactorial and is characterized by interaction of tissue damage, shock, hypothermia, acidosis and dilution. Preclinical therapy follows the concept of damage control resuscitation and involves bleeding hemostasis, permissive hypotension with a target systolic blood pressure between 80 and 90 mmHg (≥80 mmHg in presence of traumatic brain injury) by modest infusion of primarily crystalloid solutions, avoiding hypothermia and acidosis.

Conclusion: The current knowledge and therapy recommendations are presented.

Citing Articles

Navigating the 'Triangle of Death': A Multidisciplinary Approach in Severe Multi-Trauma Management.

Zhang Y, Jian F, Wang L, Chen H, Wu Z, Zhong S Clin Med Insights Case Rep. 2024; 17:11795476241271544.

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[Vascular injury-An underestimated entity?].

Jerkku T, Tsilimparis N, Banafsche R Gefasschirurgie. 2022; 27(3):156-169.

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Penetrating injuries in Germany - epidemiology, management and outcome an analysis based on the TraumaRegister DGU®.

Bieler D, Kollig E, Hackenberg L, Rathjen J, Lefering R, Franke A Scand J Trauma Resusc Emerg Med. 2021; 29(1):80.

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[Gunshot and stab wounds in Germany--epidemiology and outcome: analysis from the TraumaRegister DGU®].

Bieler D, Franke A, Hentsch S, Paffrath T, Willms A, Lefering R Unfallchirurg. 2014; 117(11):995-1004.

PMID: 25398509 DOI: 10.1007/s00113-014-2647-7.

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