Skip to main content
SpringerLink
Log in

What Can We Do During the “Golden Hour”?

  • Chapter
Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.

  • 165 Accesses

Abstract

The golden hour after trauma is spent for about 50% on the site and during transport to the hospital, the other half in the emergency department. Traditionally the focus is on the ABC of emergency care: airway, breathing and circulation, although we have stressed adequate immobilization, staunching and wound care as another priority (1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Delooz H (1991) Organization and implementation of emergency services in the treatment of major trauma. J Neurotrauma 8 [Suppl]:S7-S12

    Google Scholar 

  2. Hickling KG, Henderson SJ, Jackson RL (1990) Low mortahty associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 16:372

    Article  PubMed  CAS  Google Scholar 

  3. Simon RJ, Mawilmada S, Ivatury RR (1994) Hypercapnia: is there a cause for concern? J Trauma 37:74–81

    Article  PubMed  CAS  Google Scholar 

  4. Potkin RT, Swenson ER (1992) Resuscitation from severe acute hypercapnia. Determinants of tolerance and survival. Chest 102:1742–1745

    Article  PubMed  CAS  Google Scholar 

  5. Hoffman EK, Simonsen LO (1989) Membrane mechanisms in volume and pH regulation in vertebrate cells. Physiol Rev 69:315–382

    Google Scholar 

  6. Guyton AC, Crowell JW (1961) Dynamics of the heart in shock. Fed Proc 10:51

    Google Scholar 

  7. Shoemaker WC, Appel PL, Kram HB (1988) Tissue oxygen debt as a determinant of lethal and non lethal postoperative organ failure. Crit Care Med 16:1117–1120

    Article  PubMed  CAS  Google Scholar 

  8. Edwards JD, Redmond AD, Nightingale P, Wilkins RG (1988) Oxygen consumption following trauma: a reappraisal in severely injured patients requiring mechanical ventilation. Br J Surg 75:690–692

    Article  PubMed  CAS  Google Scholar 

  9. Cuthbertson DP (1932) Observations on the disturbance of metabohsm produced by injury to the limbs. Q J Med 1:233–246

    CAS  Google Scholar 

  10. Duchateau J, Haas M, Schreyen H, Radoux L, Sprangers I, Noel FX, Braun M, Lamy M (1984) Complement activation in patients at risk of developing the adult respiratory distress syndrome. Am Rev Respir Dis 130:1058–1064

    PubMed  CAS  Google Scholar 

  11. Larsen GL, Webster RO, Worthen GS, Gumbay RS, Henson PM (1985) Additive effect of intravascular complement activation and brief episodes of hypoxia in producing increased permeability in the rabbit lung. J Clin Invest 75:902–910

    Article  PubMed  CAS  Google Scholar 

  12. Nuytinck JKS, Goris RJA, Weerts JGE, Schilhngs PHM, Schuurmans Stekhoven JH (1986) Acute generalized microvascular injury by activated complement and hypoxia: the basis of the adult respiratory distress syndrome and multiple organ failure? Br J Exp Pathol 67:537–548

    PubMed  CAS  Google Scholar 

  13. Miller JD, Becker DP (1982) Secondary insults to the injured brain. J R Coll Surg Edinb 27:292–298

    PubMed  CAS  Google Scholar 

  14. Chesnut RM, Marshall LF, Klauber MR, Blunt BA, Baldwin N, Eisenberg HM, Jane JA, Marmarou A, Foulkes MA (1993) The role of secondary brain injury in determining outcome from severe head injury. J Trauma 34:216–222

    Article  PubMed  CAS  Google Scholar 

  15. Graham DI, Adams JH, Doyle D (1978) Ischaemic brain damage in fatal non-missile head injuries. J Neurol Sci 39:213

    Article  PubMed  CAS  Google Scholar 

  16. Pigula FA, Wald SL, Shackford SR, Vane DW (1993) The effect of hypotension and hypoxia on children with severe head injuries. J Pediatr Surg 28:310–316

    Article  PubMed  CAS  Google Scholar 

  17. Chesnut RM, Marshall SB, Piek J, Blunt BA, Klauber MR, Marshall LF (1993) Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the traumatic coma data bank. Acta Neurochir 59 [Suppl]: 121–125

    CAS  Google Scholar 

  18. Ishige N, Pitts LH, Hashimoto T, Nishimura MC, Bartkowski HM (1987) Effect of hypoxia on traumatic brain injury in rats: part 1: changes in neurological function, electroencephalograms, and histopathology. Neurosurgery 20:848–853

    Article  PubMed  CAS  Google Scholar 

  19. Cruz J (1993) On-line monitoring of global cerebral hypoxia in acute brain injury. Relationship to intracranial hypertension. J Neurosurg 79:228–233

    Article  PubMed  CAS  Google Scholar 

  20. Schmoker JD, Zhuang J, Shackford SR (1992) Hemorrhagic hypotension after brain injury causes an early and sustained reduction in cerebral oxygen delivery despite normalization of systemic oxygen delivery. J Trauma 32:714–722

    Article  PubMed  CAS  Google Scholar 

  21. Fortune JB, Bock D, Kupinski AM, Stratton HH, Shah DM, Feustel PJ (1992) Human cerebrovascular response to oxygen and carbon dioxide as determined by internal carotid artery duplex scanning. J Trauma 32:618–628

    Article  PubMed  CAS  Google Scholar 

  22. Zhuang J, Schmoker JD, Shackford SR, Pietropaoh JA (1992) Focal brain injury results in severe cerebral ischemia despite maintenance of cerebral perfusion pressure. J Trauma 33: 83–88

    Article  PubMed  CAS  Google Scholar 

  23. Bouma GJ, Muizelaar P (1992) Cerebral blood flow, cerebral blood volume, and cerebrovascular reactivity after severe head injury. J Neurotrauma 9 [Suppl]:S333-S348

    PubMed  Google Scholar 

  24. Cruz J (1993) Combined continuous monitoring of systemic and cerebral oxygenation in acute brain injury: preliminary observations. Crit Care Med 21:1225–1232

    Article  PubMed  CAS  Google Scholar 

  25. Mateer JR, Olson DW, Stueven HA, Aufderheide TP (1993) Continuous pulse oximetry during emergency endotracheal intubation. Ann Emerg Med 22:675–679

    Article  PubMed  CAS  Google Scholar 

  26. Nardi G, Massarutti D, Muzzi R, Kette F, De Monte A, Camelos GA, Peressutti R, Berlot G, Giordano F, Gullo A (1994) Impact of emergency medical helicopter service on mortality for trauma in north-east Italy. A regional prospective audit. Eur J Emerg Med 1:69–77

    Article  PubMed  CAS  Google Scholar 

  27. Trupka A, Waydhas C, Nast-Kolb D, Schweiberer (1994) Early intubation in severely injured patients. Eur J Emerg Med 1:1–8

    Article  PubMed  CAS  Google Scholar 

  28. Deakin CD (1994) Early fluid resuscitation in haemorrhagic shock. Eur J Emerg Med 1:83–85

    PubMed  CAS  Google Scholar 

  29. Lechleuthner A, Lefering R, Bouillon B, Lentke E, Vorweg M, Tiling T (1994) Prehospital detection of uncontrolled haemorrhage in blunt trauma. Eur J Emerg Med 1:13–18

    Article  PubMed  CAS  Google Scholar 

  30. Deakin C, Davies G (1994) Defining trauma patients subpopulations for field stabihzation. Eur J Emerg Med 1:31–33

    Article  PubMed  CAS  Google Scholar 

  31. Personal communication. International Resuscitation Research Conference ’94, Pittsburgh, May 5–8, 1994

    Google Scholar 

Download references

Authors
  1. H. H. Delooz
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anaesthesiology and Intensive Care, Trieste University School of Medicine, Trieste, Italy

    Antonino Gullo M.D. (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Italia, Milano

About this chapter

Cite this chapter

Delooz, H.H. (1996). What Can We Do During the “Golden Hour”?. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2203-4_44

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2203-4_44

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-3-540-75014-7

  • Online ISBN: 978-88-470-2203-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation