Development of a simple algorithm to guide the effective management of traumatic cardiac arrest
Development of a simple algorithm to guide the effective management of traumatic cardiac arrest
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DOI：
10.1016/j.resuscitation.2012.12.003
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发表时间：
2013-06-01
期刊：
影响因子：
6.5
通讯作者：
Davies, Gareth E.
中科院分区：
文献类型：
--
作者：
Lockey, David J.;Lyon, Richard M.;Davies, Gareth E.
背景：严重创伤是世界范围内年轻人死亡的主要原因。创伤性心脏骤停的死亡率仍然很高，但定期报告了重大创伤后心肺骤停的良好神经结局。如果受害者要生存，就需要进行快速有效的干预，以解决创伤性心脏骤停的潜在可逆原因。目前的ILCOR指南不包含管理创伤性心脏骤停的标准算法。我们提出了一个简单的算法来管理重大创伤患者在实际或即将发生的心脏骤停。方法：我们回顾了已发表的英文文献创伤性心脏骤停和重大创伤管理。一个治疗算法的基础上，开发了一个医生-护理人员院前创伤service.Results：该算法解决了需要治疗潜在的可逆原因的创伤性心脏骤停的一千多创伤性心脏骤停的治疗经验。这包括在穿透性胸部创伤，气道管理，优化氧合，纠正低血容量症和胸部减压，以排除张力pneumotherapy.Conclusion的情况下，立即复苏开胸术：要求迅速解决一些潜在的可逆的病理在很短的时间内借给创伤性心脏骤停的管理一个简单的治疗算法。一个标准化的方法可以防止延误诊断和治疗，并改善目前的生存率低。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Background: Major trauma is the leading worldwide cause of death in young adults. The mortality from traumatic cardiac arrest remains high but survival with good neurological outcome from cardiopulmonary arrest following major trauma has been regularly reported. Rapid, effective intervention is required to address potential reversible causes of traumatic cardiac arrest if the victim is to survive. Current ILCOR guidelines do not contain a standard algorithm for management of traumatic cardiac arrest. We present a simple algorithm to manage the major trauma patient in actual or imminent cardiac arrest.Methods: We reviewed the published English language literature on traumatic cardiac arrest and major trauma management. A treatment algorithm was developed based on this and the experience of treatment of more than a thousand traumatic cardiac arrests by a physician - paramedic pre-hospital trauma service.Results: The algorithm addresses the need treat potential reversible causes of traumatic cardiac arrest. This includes immediate resuscitative thoracotomy in cases of penetrating chest trauma, airway management, optimising oxygenation, correction of hypovolaemia and chest decompression to exclude tension pneumothorax.Conclusion: The requirement to rapidly address a number of potentially reversible pathologies in a short time period lends the management of traumatic cardiac arrest to a simple treatment algorithm. A standardised approach may prevent delay in diagnosis and treatment and improve current poor survival rates. (C) 2013 Elsevier Ireland Ltd. All rights reserved.