Kill Clemens
Zentrum für Notfallmedizin an der Klinik für Anästhesie und Intensivtherapie am Universitätsklinikum Giessen und Marburg, Standort Marburg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2007 Oct;42(10):708-14. doi: 10.1055/s-2007-993020.
The prehospital management of patients with severe trauma should focus on stabilization of vital signs. Major goal is the early transport in a specialized trauma center. After immobilization of cervical spine maintenance of oxygen delivery is the primary and most important intervention. Unconscious patients and patients with respiratory distress should receive endotracheal intubation and controlled ventilation on scene. Amounts of Infusion should be decided on blood loss, patients with traumatic brain injury need at least a normotensive blood pressure. Patients with uncontrolled severe bleeding should not receive excessive infusion before urgent surgical treatment can be performed. Prehospital induction of anesthesia must be carefully considered because of the enhanced risk.
严重创伤患者的院前管理应侧重于生命体征的稳定。主要目标是尽早转运至专业创伤中心。在固定颈椎后,维持氧输送是首要且最重要的干预措施。昏迷患者和呼吸窘迫患者应在现场接受气管插管和控制通气。输液量应根据失血量决定,创伤性脑损伤患者至少需要血压正常。在能够进行紧急手术治疗之前,严重出血无法控制的患者不应接受过多输液。由于风险增加,必须谨慎考虑院前麻醉诱导。