Nast-Kolb D, Waydhas C, Kanz K G, Schweiberer L
Chirurgische Klinik und Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-Universität München.
Unfallchirurg. 1994 Jun;97(6):292-302.
The initial management of patients with multiple trauma requires a well-defined plan of action for immediate and adequate therapy, that ensures fast recognition of life-threatening conditions and injuries. While treatment protocols for specific situations and injuries are fairly well defined, there are few such concepts for the overall management process. Therefore, we designed a comprehensive algorithm for in-hospital trauma care to give priority-based guidelines to the trauma room physician. The full management plan (diagnostic and therapeutic interventions in sequence) is implemented in seven flow charts. The first algorithm starts with the initial assessment of immediate life-threatening disorders of A (airways), B (breathing) and C (circulation) and is followed by the early stabilization and maintenance of vital functions. It is followed by six interrelated flow charts, based on disturbed physiological functions (respiration, circulation) and anatomical injuries (thorax, abdomen, head/brain, spine/pelvic girdle/extremities), which are worked up simultaneously and repeatedly. This algorithm is not only intended as an overall guideline for use the management of severely injured patients, but is also indispensable for quality assurance.
多发伤患者的初始处理需要一个明确的行动计划，以便进行即刻且充分的治疗，确保能快速识别危及生命的状况和损伤。虽然针对特定情况和损伤的治疗方案已相当明确，但对于整体管理过程却鲜有此类概念。因此，我们设计了一种用于院内创伤护理的综合算法，为创伤室医生提供基于优先级的指导方针。完整的管理计划（按顺序进行诊断和治疗干预）在七个流程图中实施。第一个算法从对A（气道）、B（呼吸）和C（循环）等即刻危及生命的病症进行初始评估开始，随后是早期稳定和维持生命功能。接着是六个相互关联的流程图，基于生理功能紊乱（呼吸、循环）和解剖损伤（胸部、腹部、头部/脑部、脊柱/骨盆带/四肢），这些会同时且反复地进行处理。该算法不仅旨在作为管理重伤患者的总体指导方针，对于质量保证也是不可或缺的。
