Wend Christopher M, Fransman Ryan B, Haut Elliott R
Department of Emergency Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street Suite 6-100, Baltimore, MD 21287, USA.
Department of Trauma, Acute Care Surgery, and Surgical Critical Care, Emory University School of Medicine, Grady Memorial Hospital, 80 Jesse Hill Jr. Drive, SE, Atlanta, GA 30303, USA.
Surg Clin North Am. 2024 Apr;104(2):267-277. doi: 10.1016/j.suc.2023.10.005. Epub 2023 Nov 18.
Prehospital trauma evaluation begins with the primary assessment of airway, breathing, circulation, disability, and exposure. This is closely followed by vital signs and a secondary assessment. Key prehospital interventions include management and resuscitation according to the aforementioned principles with a focus on major hemorrhage control, airway compromise, and invasive management of tension pneumothorax. Determining the appropriate time and method for transportation (eg, ground ambulance, helicopter, police, private vehicle) to the hospital or when to terminate resuscitation are also important decisions to be made by emergency medical services clinicians.
院前创伤评估始于对气道、呼吸、循环、残疾情况和暴露情况的初步评估。紧接着是生命体征检查和二次评估。院前关键干预措施包括根据上述原则进行管理和复苏,重点是控制大出血、处理气道梗阻以及对张力性气胸进行有创处理。确定将患者转运至医院的合适时间和方式(如地面救护车、直升机、警方车辆、私家车),或者何时终止复苏,也是急诊医疗服务临床医生需要做出的重要决策。