ABSTRACT
The patient with major trauma has the potential for many immediately life-threatening injuries. Their identification and management have been revolutionised by the development of a ‘structured approach’ to the trauma patient. Inadequate delivery of oxygen and nutrients to tissues is now recognised as the definition of shock. Haemorrhage control is the first step in managing ‘C’. This may be achieved with, e.g. pressure, splinting, pelvic sling. Aggressive fluid resuscitation to correct tissue hypoperfusion within 24 hours of injury is associated with improved clinical outcomes. Initial volume expanders of choice are crystalloids, but there is no evidence to suggest that colloid expanders are any better or worse in this function. A tension pneumothorax causes rapid deterioration in a patient’s clinical condition; arranging a chest X–ray would delay treatment with possible fatal repercussions.
