Abstract | OBJECTIVES: To describe the current state of the art regarding management of the critically ill trauma patient with an emphasis on initial management in the ICU. DATA SOURCES AND STUDY SELECTION: DATA EXTRACTION AND DATA SYNTHESIS: The basic principles of initial management of the critically ill trauma patients include rapid identification and management of life-threatening injuries with the goal of restoring tissue oxygenation and controlling hemorrhage as rapidly as possible. The initial assessment of the patient is often truncated for procedures to manage life-threatening injuries. Major, open surgical procedures have often been replaced by nonoperative or less-invasive approaches, even for critically ill patients. Consequently, much of the early management has been shifted to the ICU, where the goal is to continue resuscitation to restore homeostasis while completing the initial assessment of the patient and watching closely for failure of nonoperative management, complications of procedures, and missed injuries. CONCLUSIONS: The initial management of critically ill trauma patients is complex. Multiple, sometimes competing, priorities need to be considered. Close collaboration between the intensivist and the surgical teams is critical for optimizing patient outcomes.
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Authors | Samuel A Tisherman, Deborah M Stein |
Journal | Critical care medicine
(Crit Care Med)
Vol. 46
Issue 12
Pg. 1991-1997
(12 2018)
ISSN: 1530-0293 [Electronic] United States |
PMID | 30199391
(Publication Type: Journal Article, Review)
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Chemical References |
- Blood Coagulation Factors
|
Topics |
- Airway Management
(methods)
- Blood Coagulation Factors
(administration & dosage)
- Blood Transfusion
(methods)
- Critical Illness
(therapy)
- Emergency Medical Services
(organization & administration)
- Hemorrhage
(prevention & control)
- Humans
- Intensive Care Units
(organization & administration)
- Respiration, Artificial
(methods)
- Resuscitation
(methods)
- Shock, Hemorrhagic
(therapy)
- Tissue and Organ Procurement
(methods)
- Trauma Severity Indices
- Wounds and Injuries
(therapy)
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