[Emergency treatment of penetrating, combined thoracic- and abdominal injury. Pre-hospital i.v. fluid therapy].
We report the rare case of a penetrating, combined thoracic- and abdominal injury as a consequence of a farm work accident. During the recent years, a "treat and run" approach has been increasingly advocated as a time-saving way of treating penetrating injuries, constituting a compromise between the existing strategies of "scoop and run" (used mainly in the USA) and "stay and treat" (preferred in Central Europe). A prolonged rescue response time makes the treat and run approach impossible here. Immediate treatment at the accident site requires an appropriate provision of i.v. fluids. We examine the course of pre-hospital treatment of a trauma patient to illustrate the various approaches to i.v. fluid therapy in relation to rescue response time. However there are only a few studies with a real evidence. If "treat and run" is not possible, the outcome of patients with penetrating trauma can be influenced positively by moderate fluid therapy under continuous monitoring after having reached a constant, low mean arteria pressure (so called permissive hypotension).
Bayeff-Filloff
M
M
Arbeitsgemeinschaft Notfallmedizin der DGU, Germany. michael.bayeff-filloff@kliro.de
Beck
A
A
Lackner
Chr K
CK
Waydhas
C
C
D000007:Abdominal Injuries / Q000628:therapy*; D000062:Accidents, Occupational; D000328:Adult; D000383:Agriculture; D004632:Emergency Medical Services; D005440:Fluid Therapy; D005547:Foreign Bodies / Q000628:therapy; D005858:Germany; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000628:therapy*; D010348:Patient Care Team; D013898:Thoracic Injuries / Q000628:therapy*; D013996:Time and Motion Studies; D014950:Wounds, Penetrating / Q000628:therapy*