Therapeutic Sequences in the Acute Period in Unstable Patients

  • O. Trentz
  • H. P. Friedl
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 22)


This chapter deals with emergency treatment of severely or multiply injured victims in the resuscitation room who upon admission obviously are dying or unstable or have decompensated vital functions. Most commonly these critical conditions are exsanguinating hemorrhage, acute pump failure, obstruction of airways, mechanical failure of ventilation, or severe brain damage with tentorial herniation. A rapid survey suggests whether the trauma victim is unstable or dying, which requires urgent clearing and securing of airways, ventilatory support, massive volume infusion, and control of rapid external bleeding. Here, treatment precedes diagnosis! The first priorities of the advanced trauma life support (ATLS) course address the traditional ABCs of resuscitation: A = airway and cervical spine control, B = breathing, and C = circulation, cerebrum, cord. If effective, resuscitation cannot be achieved by conventional measures such as intubation, ventilation, and volume replacement, immediate life-saving surgical procedures are required.


Pelvic Ring Definitive Surgery Advanced Trauma Life Support Emergency Thoracotomy Traumatic Aortic Rupture 
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  1. 1.
    Millikan JS, Moore EE (1984) Outcome of resuscitative thoracotomy and descending aortic occlusion performed in the operating room. J Trauma 24:387PubMedCrossRefGoogle Scholar
  2. 2.
    Bühren V, Trentz O (1989) Intraluminäre Ballonblockade der Aorta bei traumatischer Massivblutung. Unfallchirurg 92:309PubMedGoogle Scholar
  3. 3.
    Bickell WH, Wall MJ, Pepe PE et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331:1105PubMedCrossRefGoogle Scholar
  4. 4.
    Rotondo MF, Schwab CW, McGonigal MD et al (1993) “Damage control”: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 35:375PubMedCrossRefGoogle Scholar
  5. 5.
    Morris JA, Eddy VA, Blinman TA, Rutherford EJ, Sharp KW (1993) The staged celiotomy for trauma, Issues in unpacking and reconstruction. Ann Surg 217:576PubMedCrossRefGoogle Scholar
  6. 6.
    Trentz O, Bühren V, Friedl HP (1989) Beckenverletzungen. Chirurg 60:639PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • O. Trentz
  • H. P. Friedl

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