Gondek Stephen, Schroeder Mary E, Sarani Babak
Center for Trauma and Critical Care, George Washington University Hospital, 2150 Pennsylvania Avenue Northwest, Washington, DC 20037, USA.
Center for Trauma and Critical Care, George Washington University Hospital, 2150 Pennsylvania Avenue Northwest, Washington, DC 20037, USA.
Surg Clin North Am. 2017 Oct;97(5):985-998. doi: 10.1016/j.suc.2017.06.001.
The golden hour of trauma represents a crucial period in the management of acute injury. In an efficient trauma resuscitation, the primary survey is viewed as more than simple ABCs with multiple processes running in parallel. Resuscitation efforts should be goal oriented with defined endpoints for airway management, access, and hemodynamic parameters. In tandem with resuscitation, early identification of life-threatening injuries is critical for determining the disposition of patients when they leave the trauma bay. Salvage strategies for profoundly hypotensive or pulseless patients include retrograde balloon occlusion of the aorta and resuscitative thoracotomy, with differing populations benefiting from each.
创伤黄金一小时是急性损伤救治中的关键时期。在高效的创伤复苏中,初级评估被视为不仅仅是简单的ABCs(气道、呼吸、循环),而是多个流程并行开展。复苏工作应以目标为导向,为气道管理、通路建立和血流动力学参数设定明确的终点。在进行复苏的同时,尽早识别危及生命的损伤对于确定患者离开创伤室后的处置方式至关重要。对于严重低血压或无脉的患者,挽救策略包括主动脉逆行球囊阻断术和复苏性开胸手术,不同人群可从每种策略中获益。