title: Cruciform position for trauma resuscitation.
abstract: Multiply injured patients represent a particularly demanding subgroup of trauma patients as they require urgent simultaneous clinical assessments using physical examination, ultrasound and invasive monitoring together with critical management, including tracheal intubation, thoracostomies and central venous access. Concurrent access to multiple body regions is essential to facilitate the concept of 'horizontal' resuscitation. The current positioning of trauma patient, with arms adducted, restricts this approach. Instead, the therapeutic cruciform positioning, with arms abducted at 90°, allows planning and performing of multiple life-saving interventions simultaneously. This positioning also provides a practical surgical field with improved sterility and procedural access.
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.|National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Monash Alfred Injury Network, Melbourne, Victoria, Australia.
authors.forename: Biswadev
authors.identifier: http://orcid.org/0000-0002-0508-2450
authors.initials: B
authors.lastname: Mitra
authors.affiliation: National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.|Monash Alfred Injury Network, Melbourne, Victoria, Australia.|Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Mark C
authors.identifier: http://orcid.org/0000-0003-0183-7761
authors.initials: MC
authors.lastname: Fitzgerald
authors.affiliation: National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Olaussen
authors.affiliation: National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Prasanthan
authors.initials: P
authors.lastname: Thaveenthiran
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.|National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Jordan
authors.initials: J
authors.lastname: Bade-Boon
authors.affiliation: Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Martin
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.|National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Monash Alfred Injury Network, Melbourne, Victoria, Australia.
authors.forename: De Villiers
authors.initials: V
authors.lastname: Smit
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.|National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Monash Alfred Injury Network, Melbourne, Victoria, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D056888:Patient Positioning / Q000009:adverse effects / Q000379:methods* / Q000592:standards*; D010808:Physical Examination / Q000379:methods; D012151:Resuscitation / Q000379:methods*; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*
keywords: emergency department; resuscitation; shock; wounds and injuries