Traumaresuscitation

Trauma resuscitation refers to the initial and ongoing management of patients who have sustained traumatic injuries with potential life-threatening physiologic derangements. Its aim is to rapidly assess and stabilize the patient, restore tissue perfusion, control hemorrhage, and prevent progression to irreversible organ failure. The process spans prehospital care, emergency department resuscitation, operative management, and critical care, and emphasizes avoiding iatrogenic harm such as coagulopathy, hypothermia, and acidosis.

Key components include rapid airway management and ventilation, rapid hemorrhage control, and optimization of circulation. Protocols such as damage control resuscitation prioritize early hemorrhage control and balanced transfusion, often within a massive transfusion protocol using ratios of red blood cells, plasma, and platelets. Permissive hypotension may be used in select cases to avoid dislodging forming clots. Pharmacologic adjuncts include tranexamic acid when indicated. Diagnostic tools such as focused assessment with sonography for trauma (FAST) and early rapid imaging aid in identifying bleeding sources. Rewarming and temperature maintenance, avoidance of excessive crystalloid, and correction of coagulopathy and acid-base disturbances are emphasized. Definitive control of bleeding may require surgical, endovascular, or external stabilization measures, followed by ongoing critical care support. Monitoring targets commonly include lactate or base deficit, urine output, blood pressure, and perfusion indicators. The approach is often integrated with damage control surgery principles and may involve structured teams and protocols to coordinate rapid decision-making.