Schockraummanagement Polytrauma

Bouillon, Bertil; Probst, Christian; Maegele, Marc; Wafaisade, Arasch; Helm, P.; Mutschler, Manuel; Brockamp, Thomas; Shafizadeh, Sven; Paffrath, Thomas

doi:10.1007/s00104-013-2476-1

Cited by 37 publications

(14 citation statements)

References 20 publications

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“…These guidelines include recommendations for the minimum number of required medical professionals in the trauma bay (e.g., anesthesiologists, traumatologist, neurosurgeons, nurses, technicians etc..), initial assessments according to Advanced Trauma Life Support (e.g., blood pressure measurements, respiratory rate, auscultation and examination of body regions, etc. ), and settings around the trauma bay management, such as operation room or computer tomography availability [5,6]. SARS CoV-2, a rapidly spreading pandemic, has led to increasing infection and mortality rates which threatens to overwhelm the critical care infrastructure [7].…”

Section: Introductionmentioning

confidence: 99%

The impact of SARS-CoV-2 (COVID-19) pandemic on trauma bay management and guideline adherence in a European level-one-trauma centre

Halvachizadeh

Teuben

Berk

et al. 2020

International Orthopaedics (SICOT)

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Purpose SARS CoV-2 (COVID-19) represents a pandemic that has led to adjustments of routine clinical practices. The initial management in the trauma bay follows detailed international valid algorithms. This study aims to work out potential adjustments of trauma bay algorithms during a global pandemic in order to reduce contamination and to increase safety for patients and medical personnel. Methods This retrospective cohort study compared patients admitted to the trauma bay of one academic level-one trauma centre in March and April 2019 with patients admitted in March and April 2020. Based on these datasets, possible adjustments of the current international guidelines of trauma bay management were discussed. Results Group Pan (2020, n = 30) included two-thirds the number of patients compared with Group Ref (2019, n = 44). The number of severely injured patients comparable amongst these groups: mean injury severity score (ISS) was significantly lower in Group Pan (10.5 ± 4.4 points) compared with Group Ref (15.3 ± 9.2 points, p = 0.035). Duration from admission to whole-body CT was significantly higher in Group Pan (23.8 ± 9.4 min) compared with Group Ref (17.3 ± 10.7 min, p = 0.046). Number of trauma bay admissions decreased, as did the injury severity for patients admitted in March and April 2020. In order to contain spreading of SARS Cov-2, the suggested recommendations of adjusting trauma bay protocols for severely injured patients include (1) minimizing trauma bay team members with direct contact to the patient; (2) reducing repeated examination as much as possible, with rationalized use of protective equipment; and (3) preventing potential secondary inflammatory insults. Conclusion Appropriate adjustments of trauma bay protocols during pandemics should improve safety for both patients and medical personnel while guaranteeing the optimal treatment quality. The above-mentioned proposals have the potential to improve safety during trauma bay management in a time of a global pandemic.

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Section: Introductionmentioning

confidence: 99%

The impact of SARS-CoV-2 (COVID-19) pandemic on trauma bay management and guideline adherence in a European level-one-trauma centre

Halvachizadeh

Teuben

Berk

et al. 2020

International Orthopaedics (SICOT)

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“…In emergency situations, intraosseous access is becoming the recommended method with failed or prolonged attempts at intravenous access. Furthermore, the Advanced Trauma Life Support guidelines [11] outline that intraosseous access should be obtained after three unsuccessful attempts at access to the peripheral vein, or after 2 minutes of attempts.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Intraosseous Access Devices Employed During Simulated Cardiopulmonary Resuscitation. A Prospective, Randomized, Crossover, Manikin Study

Ramirez¹,

Truszewski²,

Drozd³

2016

Disaster Emerg Med J

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BACKGROUND: Intraosseous injection is an alternative method used regarding unsuccessful intravenous access during many emergency situations. The aim of the present study was to compare injections made by the Bone Injection Gun (BIG) with NIO Adult intraosseous access devices during simulated CPR performed by paramedics. METHODS: 40 paramedics took part in this prospective, randomized, crossover, manikin study. The participants were chosen at random, while each paramedic performed an intraosseous injection with the Bone Injection Gun (BIG) or with the NIO Adult Intraosseous access device. The effectiveness of the intraosseous injection was analyzed as times T1, T2, and T3. Time T1 is defined as the time-lapse from placing the intraosseous device into one's hand to performing the intraosseous injection; Time T2 is the time-lapse from placing the intraosseous device into one's hand to the moment of stabilizing it at the injection site; while Time T3 is defined as the time-lapse from putting the intraosseous device into one's hand, attaching the syringe with a test aspiration, to connecting the infusion line. Attitudes toward the use of intraosseous access during resuscitation were also analyzed in the present study. RESULTS: The efficacy of intraosseous access obtained with the use of NIO was at 100% where the efficacy of the use of BIG was at 95%. The average time of T1 was similar in the groups randomized to use BIG and NIO, represented as 5.4 ± 3.5 vs. 3.5 ± 2.5 s, respectively (p = 0.014); the average time of T2 was 17.5 ± 4.5 vs. 3.5 ± 2.5 s, respectively (p < 0.001); while the average time of T3 was 25 ± 5.5 vs. 11.5 ± 2.5 s, respectively (p < 0.001). Notably, 90% of the study's participating paramedics preferred to use the NIO during cardiopulmonary resuscitation (p < 0.001). CONCLUSIONS: The present study shows that after a short period of training paramedics can perform an intraosseous injection with a high degree of efficiency. Thus, the authors stress the need for training medical personnel to have the skill to perform intraosseous injections along with knowledge and understanding of the indications and contraindication for IO access.

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“…Strict criteria for emergency department thoracotomy (EDT) (historically called "emergency room thoracotomy") remain controversial. Overall survival rates for patients undergoing ED thoracotomy vary from 4 to 33% across numerous studies [27][28]. This procedure should be reserved to control haemorrhage, to control the aortic outflow (aortic "cross-clamping") and to perform direct cardiac compressions.…”

Section: Oesophageal Injuriesmentioning

confidence: 99%