Prise en charge initiale d’un patient polytraumatisé aux urgences

Abstract

The initial management of severe trauma patients is based on the search and early treatment of an hemorrhage and its consequences. There is no room for improvising and extensive team experience gathered in trauma centers improves outcome. But their potential distance from the accident scene in a pathology where time is essential gives a key role to the nearest hospitals in the initial management. Indeed any delay can have short and long term pejorative consequences because of tissular hypoperfusion which justifies advanced life-support procedures in prehospital setting and damage control surgical approach. Arterial catheterization for continuous measurement of arterial pressure is the cornerstone of monitoring. A simple and rapid initial imaging assessment at bedside enables appropriate emergency decisions before further imaging assessment is performed. Echocardiography and transcranial Doppler ultrasounds are non invasive promising techniques for initial assessment and monitoring of severe trauma patients.