Kunze K
Unfallchirurgie. 1984 Apr;10(2):91-5. doi: 10.1007/BF02588385.
The therapy-free intervals after an accident have been considerably shortened by the introduction of an emergency system ensuring the treatment of the injured person by a physician on emergency duty already at the place of accident. Injuries threatening life have to be treated first in order to maintain the vital functions. Due to the lack of time and the insufficient equipment available at the place of accident, a precise diagnosis is possible only in exceptional cases. The most dangerous complications are respiratory deficiency, loss of blood, inconsciousness and lack of skeletal stability, and these are to be treated in this order. Intubation and artificial respiration are the most adequate methods to maintain the respiratory function. Exterior bleedings have to be staunched , losses of blood must be compensated by administration of colloidal solutions and electrolyte solutions. Urgent admission to a hospital is necessary in case of interior hemorrhages and in case of inconsciousness , especially if an intracranial hemorrhage is suspected. Fractures and luxations are not primarily threatening life, nevertheless the provisional reposition and immobilization of the injured extremities belong to the task of a physician on emergency duty. The reanimation of patients injured in an accident has a poor prognosis; if a cardiac arrest persists more than ten minutes, further reanimation measures are nearly never successful.
通过引入应急系统,事故后的无治疗间隔时间已大幅缩短。该应急系统确保在事故现场就有值班医生对伤者进行治疗。必须首先治疗危及生命的损伤,以维持生命功能。由于事故现场时间紧迫且设备不足,只有在特殊情况下才能进行精确诊断。最危险的并发症是呼吸功能不全、失血、意识丧失和骨骼稳定性缺失,应按此顺序进行治疗。插管和人工呼吸是维持呼吸功能的最适当方法。必须止住外部出血,通过输注胶体溶液和电解质溶液来补充失血。对于内出血和意识丧失的情况,尤其是怀疑有颅内出血时,必须紧急送往医院。骨折和脱位并非主要危及生命,但受伤肢体的临时复位和固定属于值班医生的工作任务。事故受伤患者的复苏预后不佳;如果心脏骤停持续超过十分钟,进一步的复苏措施几乎从未成功。