Author/Editor		Baraga, Andrej; Hribar-Habinc, Miša
Title		Prva oskrba hudo poškodovanega ob sprejemu v bolnišnico
Translated title		Management of polytraumatised patients early after admission to hospital
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 3. Zbornik 4. mednarodni simpozij o urgentni medicini; 1997 jun 18-21; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		1997
Volume		str. 29-45
Language		slo
Abstract		For the first management of polytraumatised patient in the early critical phase, procedures according to ATLAS protocol, i.e. integration of diagnostic and therapeutic measures, are suggested. Resuscitation on admission is a team work. The role of each member of the trauma team is firmly established. Timing of measures depends upon emergency, problems are solved as they appear, complex and sequentially. Primary survey, reanimation and life saving surgical procedures are given: life saving decompression of body cavities and control of exsangunating haemorrhage. Resuscitative measures are addressed regarding physiological systems and body regions: airway control, ventilation and monitoring of vital functions. Urgent intubation, pure oxygen ventilation and replacement of the lost blood volume are presented. Venous access and venesection are described. Special care should be given to the cervical spine which is often involved, unrecognised and thus highly endangering in the resuscitative manoeuvres. The extent and sequence of clinical, laboratory and other investigations in first minutes after admission are listed. As the patient is often hypothermic already on admission and completely exposed during examinations, special attention should be given to prevention of hypothermia. Analgesia, though most important, is often neglected. Secondary survey regarding to mechanism of accident and systematic search for previously unrecognised injuries follow. Procedure of day 1 surgery are only listed. Two protocols are added: Guidelines for the Management of Severe Head Injury (1996) and The Inhospital Phase of the Trauma Protocol (Deloooz 1992).
Descriptors		MULTIPLE TRAUMA INTENSIVE CARE UNITS RESUSCITATION ORDERS EMERGENCY SERVICE, HOSPITAL LIFE SUPPORT CARE THORACOTOMY HEMORRHAGE INTUBATION, INTRATRACHEAL