PMID: 9422131Mar 1, 1994Paper

Prehospital detection of uncontrolled haemorrhage in blunt trauma

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
A LechleuthnerT Tiling

Abstract

The field strategy for trauma victims is still controversial. The first randomized study in penetrating truncal trauma by Martin et al. (1992) supported experimental findings (Gross et al., 1988, 1989; Kowalenko et al., 1992; Krausz et al., 1992b) that fluid therapy in uncontrolled haemorrhage increases mortality. No controlled data in blunt trauma are available. In this retrospective analysis of blunt trauma victims (n = 353), the parameters systolic blood pressure, capillary refilling time and Traumascore (Champion et al., 1981) were evaluated in the prehospital detection of uncontrolled bleeding. With the CART methodology (Breiman et al., 1984) systolic blood pressure (BP) was the most sensitive parameter. Uncontrolled haemorrhage was found in nearly 50% of patients whose BP was below 90 mmHg and in 66% of those whose BP was below 50 mmHg. An accompanying traumatic brain injury (TBI) impaired the ability of BP to detect uncontrolled bleeding. Future studies evaluating prehospital fluid therapy in severe blunt trauma with a mixture of injuries, should take into account that BP in our study population classified less than 50% patients with uncontrolled haemorrhage.

Citations

Mar 21, 2013·Emergency Medicine Journal : EMJ·Luke D LawtonJeffrey Petchell
Aug 18, 2009·Journal of Critical Care·Bryan CollierJohn Morris
Sep 6, 2012·Acta Anaesthesiologica Scandinavica·R G Hahn
Apr 22, 2011·The British Journal of Surgery·K ThorsenK Søreide
Aug 16, 2005·Injury·Eldar Søreide, Charles D Deakin
Apr 23, 2004·Acta Anaesthesiologica Scandinavica·A R NakstadM Sandberg
Jul 20, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Yuru BoonMui Teng Chua

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