When the Trauma is Serious| Biomed Grid

The decisive and advanced position on emergency surgery continues to be the guiding principle in the initial treatment of serious injuries. b. Some interventions are mechanical (tourniquet), others are pharmacological (antifibrinolytic treatment) and others require new ways of thinking (early damage control surgery). c. From the first moment of the injury, the goal should be to achieve surgical arrest of the hemorrhage. d. Damage reduction surgery is a technical strategy that prioritizes the arrest of bleeding, leaves the abdominal cavity with a temporary closure and postpones all other maneuvers and surgical reconstructions for further operations. e. Most deaths due to massive hemorrhage occur within 30 minutes of the injury, therefore interventions should be immediate. f. Normotensive patients should not receive resuscitation with fluids. g. In hypotensive patients, wait until the systolic pressure approaches 80 mm Hg. h. Blood products, especially when a massive transfusion is performed, should be used in all institutions that receive patients with i. Aortic endovascular balloon resuscitation (REBOA) is a rapidly emerging technique to stop non-compressible infradiaphragmatic intracavitary hemorrhage