Intensive Care for Trauma Patients: The First 24 Hours

  • M. J. A. Parr
  • J. P. Nolan
Conference paper


Trauma patients in the Intensive Care Unit require all the complexities of modern day critical care. In an ideal world intensive care management of the seriously injured patient would start in the pre-hospital setting and continue until there was either no longer a requirement or continued treatment was considered to be futile. By definition, multi-trauma patients are critically ill from the time they receive their injuries. In some countries sophisticated pre-hospital intensive care is commenced at the scene by trained physicians but, more commonly, intensive care for trauma patients is commenced in the Emergency Department [1]. Once admitted to the Intensive Care Unit (ICU) several aspects of the continued resuscitation need to be addressed:
  • physiological optimisation which requires monitoring and intervention;

  • anatomic optimisation which requires continued assessment and planning of interventions including surgery;

  • identification of all injuries to avoid missing injuries;

  • prevention of late complications, particularly multiple organ failure. The reasons for admitting trauma patients to an ICU are diverse and include: to allow continued airway protection (intubation) and controlled ventilation;

  • continued resuscitation in an attempt to achieve appropriate haemodynamic goals. This may require the use of inotropes as well as fluids and blood products;

  • the management of severe head injuries;

  • the support of organs that are failing or that are likely to fail;

  • to permit invasive monitoring that is not available at other hospital sites; to correct coagulopathy and major metabolic derangement;

  • to permit active rewarming in those patients who are hypothermic;

  • to provide a higher level of nursing care to high risk patients e.g. the elderly and those with serious co-morbidity.


Spinal Cord Injury Cervical Spine Trauma Patient Multiple Organ Dysfunction Syndrome Abdominal Compartment Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag Italia 2000

Authors and Affiliations

  • M. J. A. Parr
  • J. P. Nolan

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