创伤评分通常分为院前和院内,院前评分主要评估伤员的伤情并明确伤员的去向和现场状况;院内评分主要针对患者的病情控制与预后。创伤评分可用于评估危重多发伤和严重创伤,减少漏诊率,提升治愈率,在减少病死率方面可发挥关键作用。本文...创伤评分通常分为院前和院内,院前评分主要评估伤员的伤情并明确伤员的去向和现场状况;院内评分主要针对患者的病情控制与预后。创伤评分可用于评估危重多发伤和严重创伤,减少漏诊率,提升治愈率,在减少病死率方面可发挥关键作用。本文从创伤指数、创伤记分、CRAMS(Circulation Respiration Abdomen Motor and Speech Score)评分法、快速急救医学评分、急诊创伤评分和创伤严重度评分方面进行分析,以期待为提升创伤评分在急诊创伤诊疗中的使用效果提供参考。展开更多
For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequ...For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system. The ＂Primary Survey＂ is performed by the emergency physician at the scene according to the Prehospital Trauma Life Support （PHTLS）-concept. The overall aim is to rapidly assess and treat life-threatening conditions even in the absence of patient history and diagnosis （＂treat-first-what-kills-first＂）. If no immediate treatment is necessary, a ＂Secondary Sur- vey＂ follows with careful and structured body examination and detailed assessment of the trauma mechanism. Massive and life-threatening states of hemorrhage should be addressed immediately even disregarding the ABCDE-scheme. Critical trauma patients should be referred without any delay （＂work and go＂） to TR-DGU certified trauma centers of the local trauma networks. Due to the difficult prehospital environment the number of quality studies in the field is low and, as consequence, the level of evidence for most recommendations is also low. Much information has been obtained from different care systems and the interchangeability of results is limited. The present article provides a synopsis of recommendations for early prehospital care for the severely injured based upon the 2011 updated multidisciplinary S3-Guideline ＂Polytrauma/Schwerstverletzten Behandlung＂, the most recently updated European Trauma guideline and the current PHTLS-algorithms including grades of recommendation whenever possible.展开更多
文摘创伤评分通常分为院前和院内,院前评分主要评估伤员的伤情并明确伤员的去向和现场状况;院内评分主要针对患者的病情控制与预后。创伤评分可用于评估危重多发伤和严重创伤,减少漏诊率,提升治愈率,在减少病死率方面可发挥关键作用。本文从创伤指数、创伤记分、CRAMS(Circulation Respiration Abdomen Motor and Speech Score)评分法、快速急救医学评分、急诊创伤评分和创伤严重度评分方面进行分析,以期待为提升创伤评分在急诊创伤诊疗中的使用效果提供参考。
文摘For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system. The ＂Primary Survey＂ is performed by the emergency physician at the scene according to the Prehospital Trauma Life Support （PHTLS）-concept. The overall aim is to rapidly assess and treat life-threatening conditions even in the absence of patient history and diagnosis （＂treat-first-what-kills-first＂）. If no immediate treatment is necessary, a ＂Secondary Sur- vey＂ follows with careful and structured body examination and detailed assessment of the trauma mechanism. Massive and life-threatening states of hemorrhage should be addressed immediately even disregarding the ABCDE-scheme. Critical trauma patients should be referred without any delay （＂work and go＂） to TR-DGU certified trauma centers of the local trauma networks. Due to the difficult prehospital environment the number of quality studies in the field is low and, as consequence, the level of evidence for most recommendations is also low. Much information has been obtained from different care systems and the interchangeability of results is limited. The present article provides a synopsis of recommendations for early prehospital care for the severely injured based upon the 2011 updated multidisciplinary S3-Guideline ＂Polytrauma/Schwerstverletzten Behandlung＂, the most recently updated European Trauma guideline and the current PHTLS-algorithms including grades of recommendation whenever possible.
