Abstract：
This review aims to provide a concise overview of the trauma management evolution in the past decade. 1) Trauma care priorities have incorporated staff protection against infection and early decision making in addition to the conventional ABCDE. 2) Five stratified levels for DAM have replaced the non-specific conventional Plans A & B. 3) CT scanning can be the tunnel to death for the hemodynamically unstable patient. 4) DPL has virtually been replaced by the FAST USG. 5) Direct whole-body MDCT provides rapid imaging diagnosis & expedites the definitive treatment but carries high radiation hazards. 6) The dynamic shock assessment by fluid resuscitation response provides more outcome-specific evaluation than the static blood volume loss model. 7) DCR comprising of permissive hypotension, hemostatic resuscitation & DCS aims to overcome the lethal triad of trauma. Early transfusion of blood components of FFP & platelet concentrates improves the outcome in massive blood transfusion. 8) DCS aims to rectify the deranged physiology and not to fully restore the damaged anatomy. 9) A pre-defined protocol for major pelvic fracture can be life-saving and the novel Pre-PPP (pre-peritoneal pelvic packing) may further reduce mortality coupled with the necessary TCAE. 10) Injury prevention is equally important if not more than the trauma resuscitation & operation.
摘要：
这篇综述旨在提供过去十年创伤管理演变的简要概述。1）除常规ABCDE外，创伤护理优先事项还包括员工对感染的保护和早期决策。2）DAM的五个分层水平已取代了非特异性常规计划A和B。3）CT扫描可能是血液动力学不稳定患者死亡的通道。4）DPL实际上已被FASTUSG取代。5）直接全身MDCT提供快速成像诊断和加速明确的治疗，但具有很高的辐射危害。6）通过液体复苏反应进行的动态休克评估比静态血容量损失模型提供了更多的结果特异性评估。7)DCR包括允许性低血压，止血复苏和DCS旨在克服致命的创伤三联征。早期输注FFP和血小板浓缩物的血液成分可改善大量输血的结果。8）DCS旨在纠正紊乱的生理机能，而不是完全恢复受损的解剖结构。9）针对严重骨盆骨折的预定义方案可以挽救生命，并且新型Pre-PPP（腹膜前骨盆填塞）可以进一步降低死亡率以及必要的TCAE。10）如果不超过创伤复苏和手术，伤害预防同样重要。
