London's Air Ambulance and Bart's Health NHS Trust, Royal London Hospital, 17th floor, London, E1 1FR, UK.
Air Ambulance Kent Surrey and Sussex, Hanger 10 Redhill Aerodrome, Redhill, UK.
Crit Care. 2022 Jun 20;26(1):184. doi: 10.1186/s13054-022-04052-7.
Early haemorrhage control and minimizing the time to definitive care have long been the cornerstones of therapy for patients exsanguinating from non-compressible haemorrhage (NCH) after penetrating injuries, as only basic treatment could be provided on scene. However, more recently, advanced on-scene treatments such as the transfusion of blood products, resuscitative thoracotomy (RT) and resuscitative endovascular balloon occlusion of the aorta (REBOA) have become available in a small number of pre-hospital critical care teams. Although these advanced techniques are included in the current traumatic cardiac arrest algorithm of the European Resuscitation Council (ERC), published in 2021, clear guidance on the practical application of these techniques in the pre-hospital setting is scarce. This paper provides a scoping review on how these advanced techniques can be incorporated into practice for the resuscitation of patients exsanguinating from NCH after penetrating injuries, based on available literature and the collective experience of several helicopter emergency medical services (HEMS) across Europe who have introduced these advanced resuscitation interventions into routine practice.
早期出血控制和将确定性治疗时间最小化一直是治疗穿透性损伤后非压迫性出血（NCH）患者的基石，因为现场只能提供基本治疗。然而，最近，一些现场急救护理团队可提供先进的现场治疗方法，如输血、开胸复律（RT）和主动脉腔内球囊阻断复苏（REBOA）。尽管这些先进技术包含在 2021 年发布的欧洲复苏委员会（ERC）创伤性心脏骤停算法中，但在现场应用这些技术的实际操作方面缺乏明确的指导。本文基于现有文献和几家在常规实践中引入这些先进复苏干预措施的欧洲直升机紧急医疗服务（HEMS）的集体经验，对如何将这些先进技术纳入 NCH 穿透性损伤后出血患者复苏的实践进行了范围综述。
