ICU · Trauma & burns

Trauma, Burns and Mass-Casualty Resuscitation

Also known as Trauma · Major trauma · Burns · Parkland formula · Damage-control surgery · Mass casualty · START triage · Injury Severity Score

Trauma is the time-critical failure of mechanical integrity — of the circulation, the airway, the brain and the skeleton — and its management is the parallel, prioritised, damage-control resuscitation of the ATLS primary survey. This topic builds the examiner's framework on the primary and the secondary survey (the ABCDE), the lethal triad of acidosis-hypothermia-coagulopathy that drives the bleeding to death, the damage-control resuscitation with tranexamic acid and the 1:1:1 transfusion ratio, the burns resuscitation (the Parkland formula and the inhalation injury), the cervical-spine clearance (the Canadian C-spine rule), the traumatic-brain-injury corticosteroid harm (the CRASH trial), the mass-casualty triage (START) and the injury scoring (the ISS and the RTS), and the evidence base — CRASH-2 for tranexamic acid and the Canadian C-spine rule for the clearance of the alert, stable patient.