Rommens P M, Carlier H, Delooz H H
Dienst Algemene Heelkunde en Traumatologie, Universitaire Ziekenhuizen Leuven.
Acta Chir Belg. 1988 Nov-Dec;88(6):375-9.
Early mortality after polytrauma: a retrospective study. The medical charts of all patients, who died in 1986 in the reanimation phase after an accident, were reviewed. Twenty-five patients (86%) were victim of a traffic accident, 2 of an accident at work and 2 of an accident at home. The average ISS of the 29 patients was 40.7. The patients, who received the first aid at the place of accident from an emergency doctor, had an average ISS of 44.2. The patients, who received the first aid from a team without doctor had an average ISS of 33.8. The first aid was given after an average time of 10 minutes. Ten patients were transported during the reanimation phase from the first hospital to our trauma center. Eighteen patients died due to a severe craniocerebral trauma, eight of them were transported secondarily. Six patients died due to hemorrhagic shock, only in two patients an emergency doctor was at the place of accident. Five patients died due to asphyxia after a thoracic trauma. This retrospective study clearly demonstrates that the first aid of a polytraumatized patient must be given at the place of accident by an emergency doctor, that a quick and direct transport to a regional trauma center is desirable, that a more aggressive shock therapy is necessary and that the first aid-team must be able to evacuate a tension-pneumothorax at the preclinical scene.
一项回顾性研究。对1986年所有在事故复苏阶段死亡患者的病历进行了审查。25名患者（86%）为交通事故受害者，2名是工伤事故受害者，2名是家庭事故受害者。29名患者的平均损伤严重度评分（ISS）为40.7。在事故现场接受急诊医生急救的患者，其平均ISS为44.2。接受无医生团队急救的患者，其平均ISS为33.8。急救平均在10分钟后进行。10名患者在复苏阶段从第一家医院转至我们的创伤中心。18名患者死于严重颅脑创伤，其中8名是二次转运而来。6名患者死于失血性休克，事故现场只有2名患者有急诊医生。5名患者在胸部创伤后死于窒息。这项回顾性研究清楚地表明，多发伤患者的急救必须由急诊医生在事故现场进行，需要快速直接转运至区域创伤中心，需要更积极的休克治疗，并且急救团队必须能够在临床前现场排出张力性气胸。
