Michael Mark, Hossfeld Björn, Bernhard Michael
Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Heinrich-Heine Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Department für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerzmedizin, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland.
Radiologie (Heidelb). 2025 Jan;65(1):4-12. doi: 10.1007/s00117-024-01384-z. Epub 2024 Nov 17.
Acute bleeding often occurs in a wide variety of forms in clinical emergency medicine. In traumatic bleeding, soft tissue injuries to the head or extremities are common, while severe bleeding is less common in chest injuries or pelvic trauma. In nontraumatic emergencies, gastrointestinal bleeding is the leading cause, but many other bleeding entities are possible. Structured management helps to detect the critically ill patient, identify the possible source of bleeding and provide appropriate radiological diagnostics and therapy. Clinical examination, blood gas analyses and emergency ultrasound are crucial in the initial phase of diagnosis. Initially, symptomatic therapy is usually indicated to stabilize the patient, and then interventional or surgical care is indicated in the course of the disease, depending on the location of the bleeding. Volume and catecholamine therapy, coagulation management and emergency transfusion are important components of interdisciplinary emergency care, in addition to primary bleeding control, especially in the case of open injuries.
急性出血在临床急诊医学中常以多种形式出现。在外伤性出血中,头部或四肢的软组织损伤较为常见,而胸部损伤或骨盆创伤中严重出血则较少见。在非外伤性急症中,胃肠道出血是主要原因,但也可能有许多其他出血情况。结构化管理有助于发现重症患者,确定可能的出血源,并提供适当的放射学诊断和治疗。临床检查、血气分析和急诊超声在诊断的初始阶段至关重要。最初,通常需要进行对症治疗以稳定患者病情,然后根据出血部位在病程中进行介入或手术治疗。除了主要的出血控制外,容量和儿茶酚胺治疗、凝血管理和急诊输血是多学科急诊护理的重要组成部分,尤其是在开放性损伤的情况下。