COMPREHENSIVE ALGORITHM FOR IN-HOSPITAL M ANAGEMENT OF MULTIPLE TRAUMA

The initial management of patients with multiple trauma requires a wel l-defined plan of action for immediate and adequate therapy, that ensu res fast recognition of life-threatening conditions and injuries. Whil e treatment protocols for specific situations and injuries are fairly well defined, there are few such concepts for the overall management p rocess. Therefore, we designed a comprehensive algorithm for in-hospit al trauma care to give priority-based guidelines to the trauma room ph ysician. The full management plan (diagnostic and therapeutic interven tions in sequence) is implemented in seven flow charts. The first algo rithm starts with the initial assessment of immediate life-threatening disorders of A (airways), B (breathing) and C (circulation) and is fo llowed by the early stabilization and maintenance of vital functions. It is followed by six interrelated flow charts, based on disturbed phy siological functions (respiration, circulation) and anatomical injurie s (thorax, abdomen, head/brain, spine/pelvic girdle/extremities), whic h are worked up simultaneously and repeatedly. This algorithm is not o nly intended as an overall guideline for use the management of severel y injured patients, but is also indispensable for quality assurance.