Trauma Management: From the Field to the Emergency Department

  • G. Nardi
  • S. Di Bartolomeo
  • V. Michelutto
Conference paper


The goal of pre-hospital trauma care is to reduce mortality and morbidity by preventing the development of hypovolaemia, hypoxia, hypercapnia and acidosis, and to ensure, at the same time, the quickest access to a Centre of definitive care and to early surgery when needed.


Trauma Patient Emergency Helicopter Medical Service Advanced Life Support Tension Pneumothorax Trauma Management 


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  1. 1.
    Sampalis JS, Lavoie A, Williams JL et al (1993) Impact of on-site care, prehospital time and level of in-hospital care on survival in severely injured patients. J Trauma 34:(2)256–261Google Scholar
  2. 2.
    Nardi G, Massarutti D, Muzzi R et al (1994) Impact of emergency medical helicopter service on mortality for trauma in Nort-East Italy. A regional prospective audit. European J Emerg Med (1)69–77Google Scholar
  3. 3.
    Schuttler J, Schmitz B, Bartsh AC et al (1995) The efficiency of emergency therapy in patients with head-brain, multiple injury. Quality assurance in emergency medicine. Anaesthesist 44 (12): 850–858PubMedCrossRefGoogle Scholar
  4. 4.
    Lerer LB, Knottenbelt JD (1994) Preventable mortality following sharp penetrating chest trauma. J Trauma 37(1)6–12Google Scholar
  5. 5.
    Pepe PE (1995) Resuscitation of the patient with major trauma. Current Opin Crit Care 1: 479–486CrossRefGoogle Scholar
  6. 6.
    Winchell R, Hoyt DB (1997) Endotracheal intubation in the field improves survival in patients with severe head injury. Arch Surg 132: 592–597PubMedCrossRefGoogle Scholar
  7. 7.
    Frankel H, Rozycki G, Champion H et al (1997) The use of TRISS methodology to validate prehospital intubation by urban EMS providers. Am J Emerg Med 15: 630–632PubMedCrossRefGoogle Scholar
  8. 8.
    Oswalt JL, Hedges JR, Soifer BE (1992) Analysis of trauma intubations. Am J Emerg Med 10: 6 (511–514)Google Scholar
  9. 9.
    Adnet F, Lapostolle F, Boiron S et al (1997) Optimization of glottic exposure during intubation of a patient lying supine on the ground. Am J Emerg Med 15: 1–3CrossRefGoogle Scholar
  10. 10.
    Vilke GM, Hoyt DB, Epperson M et al (1994) Intubation techniques in the helicopter. J Emerg Med 12:(2)217–224Google Scholar
  11. 11.
    Criswell JC, Parr MJA (1994) Emergency airway management in patients with cervical spine injuries. Anaesthesia 49: 900–903PubMedCrossRefGoogle Scholar
  12. 12.
    Nardi G, Lattuada L, Scian F and the FVG Major Trauma Study Group (1999) Epidemiological study on high grade trauma 13 Min. Anest 65: 6 (348–352)Google Scholar
  13. 13.
    Schmidt U, Frame SB, Nerlich ML et al (1992) On-scene helicopter transport of patients with multiple injuries-comparison of a German and an American system. J Trauma 33; 4: 548–553PubMedCrossRefGoogle Scholar
  14. 14.
    Baldt MM, Bankier AA, Germann PS et al (1995) Complications after emergency thoracotomy: assessment with CT. Radiology 195: 539–543PubMedGoogle Scholar
  15. 15.
    Schmidt U, Stalp M, Gerich T et al (1998) Chest tube decompression of blunt chest injuries by physicians in the field: effectiveness and complications. J Trauma 44: 98–101PubMedCrossRefGoogle Scholar
  16. 16.
    Deakin CD, Davies G, Wilson A (1995) Simple thoracostomy avoids chest drain insertion in prehospital trauma. J of Trauma 39: 373–374CrossRefGoogle Scholar
  17. 17.
    Italian Resuscitation Council Trauma Committee (1998) Prehospital Trauma Care. IRC ed Compositori BolognaGoogle Scholar
  18. 18.
    Kaweski SM, Sise MJ, Virgilio RW (1990) The effect of prehospital fluids on survival in trauma patients. Journal of Trauma 30: 1215–1218PubMedCrossRefGoogle Scholar
  19. 19.
    Bickell WH, Wall MJ, Pepe PE (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331: 1105–1109PubMedCrossRefGoogle Scholar
  20. 20.
    Chestnut RM, Marshall LF, Klauber MR (1992) The role of secondary brain injury in determining outcome from severe head injury. J Trauma 34: 216–222CrossRefGoogle Scholar
  21. 21.
    Zornow MH, Prough DS (1995) Fluid management in patient with traumatic brain injury. New Horizon 3: 488–493Google Scholar
  22. 22.
    Bullock R, Chestnut R, Clifton G (1996) Guidelines for the management of severe head injury. Brain Trauma Foundation, New YorkGoogle Scholar
  23. 23.
    Maas AIR (1996) Guidelines for management of severe head injury in adults. In: JL Vincent (ed) 1996 Yearbook of Intensive Care and Emergency Medicine. Springer, pp 707–715CrossRefGoogle Scholar
  24. 24.
    Riddez L, Johnson L, Hahn RG (1998) Central and regional hemodynamics during crystalloid fluid therapy after uncontrolled intra-abdominal bleeding. J Trauma 44: 433–439PubMedCrossRefGoogle Scholar
  25. 25.
    Wade CE, Grady JJ, Kramer GC et al (1997) Individual patient cohort analysis of the efficacy of hypertonic saline/dextran in patients with traumatic brain injury and hypotension. J Trauma 42: S61 - S65PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • G. Nardi
  • S. Di Bartolomeo
  • V. Michelutto

There are no affiliations available

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