Abstract
ObjectiveUncontrolled hemorrhagic shock is a significant factor in death of severe multiple trauma patients. The acute management of injured bleeding in emergency department (ED) may improve patient outcomes. The medical records of severe multiple trauma patients with hemorrhagic shock in our ED were reviewed to summarize an evidence-based approach to the management of critically injured bleeding trauma patients.MethodsA retrospective study was carried out from January 2002 to December 2011 in a Chinese tertiary hospital. Clinical data from major trauma patients with hemorrhagic shock admitted to ED were evaluated. The patients were stratified based on the characteristics of traumatic condition and resuscitation strategies. The medical treatments and the outcomes of these severe multiple trauma patients were described.ResultsA total of 1120 major trauma patients, consisting of 832 males and 288 females, were enrolled. 906 of the patients (80.9%) were injured in traffic accidents, 104 (9.3%) from falling, and 100 from other reasons. The number of injured sites varied from 2 to 6, 616(55.0%) more than 3. 902 (80.5%) trauma patients have recovered and been discharged from hospital.ConclusionsUncontrolled hemorrhagic shock is a main reason of trauma patients’ death. The resuscitation strategy should center upon permissive hypotension and early hemostatic resuscitation combined identified and corrects coagulopathy. The current approach to the management of critically injured bleeding trauma patients is able to improve patient outcomes.
Highlights
The care of major trauma patients continues to be a challenge for emergency physicians and trauma surgeons
Medical treatments Upon the patients arriving in emergency department (ED), emergency doctors rapidly make a preliminary assessment of the traumatic conditions through observing consciousness level and respiratory rhythm, monitoring heart rate and blood pressure, examining chest, abdomen and limb activity
94 (8.4%) patients died in the rescue room before been transported to emergency intensive care unit (EICU), 124(11.1%) died or withdrawal of therapy by the family due to medical expenses and other reasons in EICU. 902 (80.5%) trauma patients recovered, and were discharged from hospital
Summary
The care of major trauma patients continues to be a challenge for emergency physicians and trauma surgeons. Uncontrolled hemorrhagic shock is a significant factor in death of severe multiple trauma patients [1]. It is estimated that acute management of injured bleeding in emergency department (ED) could improve patient outcomes [2]. Doctors believe that resuscitation strategies should be carried out as soon as possible [3]. The present study was undertaken to analyze the medical records of severe multiple trauma patients with hemorrhagic shock, with the objective of providing a
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