Anaesthesia concerns in the management of the trauma patient

Abstract 

The complex total body response to trauma, it is obvious that only “Damage control” surgery be performed initially. This is essentially early control of surgical bleeding and prevention of pathogenic contamination together with aggressive fluid resuscitation, management of coagulopathy and correction of hypothermia. For example consider a patient with multiple injuries undergoing trauma laparotomy and after receiving massive blood transfusion is now hypothermic and coagulopathic—is this the right time to fix his orthopaedic fracture? Clearly, the patient would benefit from a period in the Intensive Care Unit to correct the pathophysiological abnormalities and until then can be managed with conservative irrigation, splinting and antibiotic coverage. Prior to booking the patient for definitive orthopaedic fixation, the patient should be re-assessed and attention to the patient's:

Use of the above criteria will ensure patient optimisation for surgery and better intra- and post-operative outcome.

Keywords:  Adult trauma, Anaesthetic concerns airway management, Acid base, Fluid resuscitation, Coagulopathy, Hypothermia