The Treatment of Patients With Severe and Multiple Traumatic Injuries.

Background: The care of severely and multiply injured patients is an interdisciplinary challenge. The only existing German-language guideline up to now has been the S1-guideline issued in 2002 by the German Society for Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie, DGU). In this article,...

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Publicado en:Deutsches Ärzteblatt International Vol. 109; no. 6; pp. 102 - 109
Autores principales: Neugebauer, Edmund A. M., Waydhas, Christian, Lendemans, Sven, Rixen, Dieter, Eikermann, Michaela, Pohlemann, Tim
Formato: practice guidelines research systematic review tables/charts Journal Article
Publicado: Deutscher Aerzte-Verlag GmbH 2/10/2012
Acceso en línea:Ver este registro en EBSCOhost
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        atl: The Treatment of Patients With Severe and Multiple Traumatic Injuries.
      aug:
        au:
          Neugebauer, Edmund A. M.
          Waydhas, Christian
          Lendemans, Sven
          Rixen, Dieter
          Eikermann, Michaela
          Pohlemann, Tim
        affil: Institut für Forschung in der Operativen Medizin (IFOM) Universität Witten/Herdecke, Campus Köln-Merheim
      sug:
        subj:
          Multiple Trauma Therapy
          Severity of Injury
          Multidisciplinary Care Team
          Human
          Germany
          Practice Guidelines
          Medical Organizations
          Delphi Technique
          Prehospital Care
          Emergency Care
          Decision Making, Clinical
      ab: Background: The care of severely and multiply injured patients is an interdisciplinary challenge. The only existing German-language guideline up to now has been the S1-guideline issued in 2002 by the German Society for Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie, DGU). In this article, we present a new, comprehensive, evidence and consensus based S3-guideline for the treatment of severely and multiply injured patients in the pre-hospital and early in-hospital phases which has been developed with the aim of structural and procedural quality optimization. Its implementation should lower these patients' mortality and improve their quality of life. Methods: The guideline was developed by a panel consisting of 18 delegates from 11 specialty societies under the lead of the DGU, with designated coordinators for each of three phases of treatment: the pre-hospital phase, the emergency-room phase, and the emergency surgery phase. The key questions to be answered were determined by vote, and then the relevant literature (in English and German, 1995-2010) was systematically searched and evaluated. Key recommendations with explanatory texts were formulated and agreed upon in a nominal group process (NGP) with five consensus conferences and three further Delphi rounds. Results: 264 recommendations were issued: 66 for the pre-hospital phase, 102 for the emergency-room phase, and 96 for the emergency surgery phase. The three phases were subcategorized according to organizational and anatomical considerations. Topics of major emphasis were, in the pre-hospital phase, the establishment and implementation of correct priorities for treatment; in the emergency-room phase, the creation of clear structures and processes; and, in the emergency surgery phase, the avoidance of secondary injury (i.e., the principle of damage control). Conclusion: This guideline can only improve outcomes if it is implemented in routine practice. Aside from the guideline itself, the DGU trauma network (www.dgu-traumanetzwerk.de) has issued a set of directions as an aid to its implementation.
      pubtype: Academic Journal
      doctype:
        practice guidelines
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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