Resuscitation Resequenced: A Rational Approach to Patients with Trauma in Shock

Andrew Petrosoniak; Christopher Hicks

doi:10.1016/j.emc.2017.08.005

Resuscitation Resequenced: A Rational Approach to Patients with Trauma in Shock

Emerg Med Clin North Am. 2018 Feb;36(1):41-60. doi: 10.1016/j.emc.2017.08.005.

Authors

Andrew Petrosoniak¹, Christopher Hicks²

Affiliations

¹ Department of Emergency Medicine, St. Michael's Hospital, 1-008c Shuter Wing, 30 Bond street, Toronto, Ontario M5B 1W8, Canada. Electronic address: petro82@gmail.com.
² Department of Emergency Medicine, St. Michael's Hospital, 1-008c Shuter Wing, 30 Bond street, Toronto, Ontario M5B 1W8, Canada.

PMID: 29132581
DOI: 10.1016/j.emc.2017.08.005

Abstract

Trauma resuscitation is a complex and dynamic process that requires a high-performing team to optimize patient outcomes. More than 30 years ago, Advanced Trauma Life Support was developed to formalize and standardize trauma care; however, the sequential nature of the algorithm that is used can lead to ineffective prioritization. An improved understanding of shock mandates an updated approach to trauma resuscitation. This article proposes a resequenced approach that (1) addresses immediate threats to life and (2) targets strategies for the diagnosis and management of shock causes. This updated approach emphasizes evidence-based resuscitation principles that align with physiologic priorities.

Keywords: ATLS; Resuscitation; Shock; Shock index; Trauma.

Publication types

Review

MeSH terms

Advanced Cardiac Life Support / methods
Humans
Resuscitation / methods*
Shock / diagnosis
Shock / etiology
Shock / therapy*
Wounds and Injuries / complications
Wounds and Injuries / therapy*