Burns C M
Can J Surg. 1984 Sep;27(5):461-3.
Immediate surgery is essential to resuscitate and save 5% to 10% of those suffering life-threatening trauma. Recently, emergency room surgery has been proposed as the procedure to follow in stabilizing such patients. Over a 3-year period, 41 moribund patients were treated by the trauma service at the Health Sciences Centre in Winnipeg. All were managed in the main operating theatre following a "crash protocol" for immediate surgery. Twenty-three patients arrived in cardiac arrest or with an unrecordable blood pressure; of these, 4 (17%) survived. Eighteen patients had a blood pressure of 70 mm Hg systolic or less and failed to respond to massive O positive blood transfusion; of these, 14 (77%) survived. The mix of mode of injury and injury severity scoring is important to compare results from within and between centres. The author's experience indicates that the use of a high-priority crash protocol for managing moribund patients with life-threatening traumatic injury in the main operating room provides a standard of care equal to or better than that reported for emergency room surgery.
立即进行手术对于挽救5%至10%遭受危及生命创伤的患者至关重要。最近，有人提议将急诊室手术作为稳定此类患者病情的后续程序。在三年时间里，温尼伯健康科学中心的创伤科对41名濒死患者进行了治疗。所有患者均在主手术室按照立即手术的“紧急预案”进行处理。23名患者到达时心脏骤停或血压无法记录；其中4名（17%）存活。18名患者收缩压为70毫米汞柱或更低，且对大量O型阳性输血无反应；其中14名（77%）存活。损伤方式和损伤严重程度评分的组合对于比较中心内部和中心之间的结果很重要。作者的经验表明，在主手术室使用高优先级的紧急预案来处理患有危及生命的创伤性损伤的濒死患者，所提供的护理标准等于或优于急诊室手术所报告的标准。
