https://genoplivning.dk/wp-content/uploads/2013/07/european-resuscitation-council-guidelines-for-resuscitation-2010-section-4-adult-advanced-life-support.pdf

European Resuscitation Council Guidelines for Resuscitation 2010 Section 4 Adult advanced life support

European Resuscitation Council Guidelines for Resuscitation.

Severe trauma continues to represent a global public health issue and mortality and morbidity in trauma patients remains substantial. A number of initiatives have aimed to provide guidance on the management of trauma patients. This document focuses on the management of major bleeding and coagulopathy following trauma and encourages adaptation of the guiding principles to each local situation and implementation within each institution. The pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma was founded in 2004 and included representatives of six relevant European professional societies. The group used a structured, evidence-based consensus approach to address scientific queries that served as the basis for each recommendation and supporting rationale. Expert opinion and current clinical practice were also considered, particularly in areas in which randomised clinical trials have not or cannot be performed. Existing recommendations were reconsidered and revised based on new scientific evidence and observed shifts in clinical practice; new recommendations were formulated to reflect current clinical concerns and areas in which new research data have been generated. This guideline represents the fourth edition of a document first published in 2007 and updated in 2010 and 2013. The guideline now recommends that patients be transferred directly to an appropriate trauma treatment centre and encourages use of a restricted volume replacement strategy during initial resuscitation. Best-practice use of blood products during further resuscitation continues to evolve and should be guided by a goal-directed strategy. The identification and management of patients pre-treated with anticoagulant agents continues to pose a real challenge, despite accumulating experience and awareness. The present guideline should be viewed as an educational aid to improve and standardise the care of the bleeding trauma patients across Europe and beyond. This document may also serve as a basis for local implementation. Furthermore, local quality and safety management systems need to be established to specifically assess key measures of bleeding control and outcome. A multidisciplinary approach and adherence to evidence-based guidance are key to improving patient outcomes. The implementation of locally adapted treatment algorithms should strive to achieve measureable improvements in patient outcome.

/pdf/the-european-guideline-on-management-of-major-bleeding-and-50g3zxrre8.pdf

The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition

https://anestesiar.org/WP/uploads/2011/01/7-neonatos-ERC-2010.pdf

European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary.

European Resuscitation Council Guidelines for Resuscitation 2015

https://heeoe.hee.nhs.uk/sites/default/files/130220p_whole_body_ct.pdf

Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study

During the past two decades, digital radiography has supplanted screen-film radiography in many radiology departments. Today, manufacturers provide a variety of digital imaging solutions based on various detector and readout technologies. Digital detectors allow implementation of a fully digital picture archiving and communication system, in which images are stored digitally and are available anytime. Image distribution in hospitals can now be achieved electronically by means of web-based technology with no risk of losing images. Other advantages of digital radiography include higher patient throughput, increased dose efficiency, and the greater dynamic range of digital detectors with possible reduction of radiation exposure to the patient. The future of radiography will be digital, and it behooves radiologists to be familiar with the technical principles, image quality criteria, and radiation exposure issues associated with the various digital radiography systems that are currently available.

https://pubs.rsna.org/doi/pdf/10.1148/rg.273065075?frame=sidebar

Advances in digital radiography: physical principles and system overview.

Our experimental data suggest that the use of model-based iterative reconstruction considerably improved image quality compared with that of both the adaptive statistical iterative reconstruction algorithm and the noniterative filtered back projection.

Filtered Back Projection, Adaptive Statistical Iterative Reconstruction, and a Model-based Iterative Reconstruction in Abdominal CT: An Experimental Clinical Study

In patients with major trauma, focused abdominal ultrasonography (US) often is the initial imaging examination. US is readily available, requires minimal preparation time, and may be performed with mobile equipment that allows greater flexibility in patient positioning than is possible with other modalities. It also is effective in depicting abnormally large intraperitoneal collections of free fluid, which are indirect evidence of a solid organ injury that requires immediate surgery. However, because US has poor sensitivity for the detection of most solid organ injuries, an initial survey with US often is followed by a more thorough examination with multidetector computed tomography (CT). The initial US examination is generally performed with a FAST (focused assessment with sonography in trauma) protocol. Speed is important because if intraabdominal bleeding is present, the probability of death increases by about 1% for every 3 minutes that elapses before intervention. Typical sites of fluid accumulation ...

https://pubs.rsna.org/doi/pdf/10.1148/rg.281075047

Current Role of Emergency US in Patients with Major Trauma

In major trauma it is essential to immediately recognize and treat life-threatening problems and conditions Most trauma protocols reserve the use of computed tomography for the secondary survey, as patients cannot be attended to during the examination and must be transferred from the emergency room to the CT suite The relevant reduction in the scanning time of multidetector computed tomography (MDCT) or multislice computed tomography (MSCT) justifies its use as the major diagnostic adjunct for primary trauma survey and initial resuscitation According to our ATLS((R))-based trauma algorithm, the multidetector scanner situated in the emergency department is utilized immediately after the correction of respiratory problems to detect causes of bleeding or intracranial hematomas In a prospective series a total of 125 consecutive major trauma patients were evaluated After focused sonography in trauma (FAST) and plain chest films in intubated patients, whole body MDCT was performed By retrieving data from our trauma registry and a picture archiving and communication system (PACS), time from trauma room admission to the end of head CT scan for the entire MDCT study and calculation of multiplanar reconstruction (MPR) was analyzed Additionally, relevant complications such as untreated tension pneumothorax or circulatory arrest during MDCT examination were recorded The time from admission to the trauma room until completion of head CT scan without contrast was 21:12 min (median, IQR 18:13-27:52) The entire contrast-enhanced MDCT study, including pilot scan and contrast application, required 6:08 min (median, IQR 4:33-8:14) with a total scanning time of 0:59 min (median, IQR 0:55-1:03) MPR calculation of the spine and bony pelvis was performed in 11:37 min (median, IQR 8:03-16:41) A relevant life-threatening complication due to CT scanning during primary trauma survey was not observed in the 125 cases (0/125 CI 95% 0%-3%) Complete diagnostic imaging can be performed within 30 min after trauma room admission by using MDCT During the primary survey, treatment of the patient is interrupted just for the few minutes of the CT scan and contrast application An adequate survey of injuries can be achieved earlier and a targeted therapy can be initiated ahead of time Integration of MDCT scanners in the primary trauma survey provides a high standard of imaging in a very short time without endangering the patient When dealing with multiple casualties, MDCT could be used also as an accurate and time-efficient means of hospital triage to diagnose and prioritize patients and to plan further surgical interventions and intensive care

Markus Körner

Papers

Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study

Advances in digital radiography: physical principles and system overview.

Filtered Back Projection, Adaptive Statistical Iterative Reconstruction, and a Model-based Iterative Reconstruction in Abdominal CT: An Experimental Clinical Study

Current Role of Emergency US in Patients with Major Trauma

[Priority-oriented shock trauma room management with the integration of multiple-view spiral computed tomography].