Emergency care of multiple trauma.docVIP

 PAGE \* MERGEFORMAT 9 Emergency care of multiple trauma [Abstract] multiple trauma is caused by the same factor of two or more injured anatomic site or organ trauma, and at least one injury is life-threatening. Should be distinguished from combined injuries, combined injuries is two or two traumatic injury caused by these factors. [Keywords:] multiple trauma emergency care 1 Clinical data 1.1 General information on 126 cases of this group of patients, male 84 cases, 42 female, aged more than 20 to 50 years old, from injury to treatment time is about 20 ~ 120min. Injury factors: 101 cases of traffic accidents, fall injuries in 11 cases, knifed injury in 12 cases, 2 cases of subsidence damage. Injuries: The 74 cases of head injury based, mainly chest and abdominal injuries in 38 cases, mainly of the limbs in 14 cases of pelvic injury. 1.2 Etiology and pathogenesis of multiple trauma often caused by falls, traffic accidents, bury, explosions and other factors. Severe multiple trauma is associated with a complex stress response. Sharp decline in blood volume after trauma, tissue hypoperfusion and hypoxia and a series of threatening the survival of the pathophysiology of tissue may be difficult to improve a long time. These injuries change quickly so serious disorder, often a series of complications rapidly life-threatening injuries, so the higher mortality rate. 1.3 Clinical features 1.3.1 The high mortality in patients with multiple injuries has three peaks of mortality (1) The first peak of death: within a few minutes immediately after injury, death. The main reason for brain death, brain stem, high spinal cord injury or serious heart, great vessels of aortic rupture or tear. (2) The second peak of death: 6 to 8 hours after injury, known as the rescue of the “golden time.” Primary cause of death for the brain, subdural and epidural hematoma, pneumothorax blood, liver, spleen, pelvis and femur fracture and multiple ble