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Prehospital Care and In-Hospital Initial Trauma Management

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Operative Techniques and Recent Advances in Acute Care and Emergency Surgery

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Abstract

Trauma care is a time-sensitive emergency. Prehospital and in-hospital early care are the two necessarily interlaced crucial phases in the management of severe traumatic injuries, with potential impact on the survival of patients. While the main goals of an effective prehospital trauma system are clearly recognized, the relative impact on patient’s outcome of different approaches has yet to be established. The diversity among healthcare systems of different countries and the scarcity of high-quality evidence make it difficult to reach a consensus on essentially every aspect of prehospital trauma management. Once arrived at the selected trauma center, within dedicated areas of the emergency department, trauma victims should be assessed and treated by a specifically trained multidisciplinary trauma team, directed by a team leader, according to pre-specified institutional algorithms. Following a classic ABCDE method, thorough stepwise evaluations of the patient, and simultaneous emergency damage control maneuvers, are performed, prior to directing the patient to a definitive care plan. The management of trauma patients involves extremely complex logistics, across several levels of any healthcare system. Multiple providers with different training, both pre- and in-hospital, are called to face technical, organizational, clinical, and communication challenges, in a significantly time-constrained situation.

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Author information

Authors and Affiliations

  1. University of Milan-Bicocca Medical School, Monza, MB, Italy

    Riccardo Pinciroli, Emanuele Vassena & Simone Checchi

  2. Anesthesia and Intensive Care 1, ASST Grande Ospedale Metropolitano Niguarda, Milan, MI, Italy

    Riccardo Pinciroli & Gabriele Bassi

  3. Emergency Department, Anesthesia and Intensive Care Unit, M. Bufalini Hospital, Cesena, CE, Italy

    Giacinto Pizzilli

  4. Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, MI, Italy

    Monica Ghinaglia & Gabriele Bassi

Authors
  1. Riccardo Pinciroli
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  2. Giacinto Pizzilli
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  3. Emanuele Vassena
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  4. Simone Checchi
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  5. Monica Ghinaglia
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  6. Gabriele Bassi
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Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Milano, Italy

    Paolo Aseni

  2. School of Medicine, University of Milano-Bicocca, Niguarda Hospital, Milan, Milano, Italy

    Luciano De Carlis

  3. Department of Cardiac Surgery, IRCCS MultiMedica, Milan, Milano, Italy

    Alessandro Mazzola

  4. Department of Cardiac Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy

    Antonino M. Grande

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Pinciroli, R., Pizzilli, G., Vassena, E., Checchi, S., Ghinaglia, M., Bassi, G. (2019). Prehospital Care and In-Hospital Initial Trauma Management. In: Aseni, P., De Carlis, L., Mazzola, A., Grande, A.M. (eds) Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95114-0_8

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  • DOI: https://doi.org/10.1007/978-3-319-95114-0_8

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95113-3

  • Online ISBN: 978-3-319-95114-0

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