Principles and Management of Severe Trauma and Bleeding

Abstract

Severe trauma is a major global health problem and one of the leading causes of death among young people. Severe trauma is a time-dependent disease, so care should be coordinated, continuous and with constant re-evaluation. Clinicians must rapidly assess the patient using a systematic approach and institute life-saving manoeuvres when needed. The primary survey is the initial assessment and management of a trauma patient. It is conducted to detect and treat actual or imminent life threats and prevent complications from these injuries. The most common acronym for performing the primary trauma survey is ABCDE, each letter representing an area of focus. Once the patient has been resuscitated and stabilised, the secondary survey is performed. It involves a more thorough head-to-toe examination and a complete history. By far, the most common cause of shock in these patients is bleeding. Once tension pneumothorax has been ruled out, hypotension is due to blood loss until proven otherwise. Definitive bleeding control, being surgical or interventional radiological treatment, is paramount together with volume resuscitation.