Guidelines for Prehospital Care in Severe Trauma Injuries

Effective prehospital management can significantly impact outcomes in patients with multiple and severe injuries.

Begin fluid replacement in severely injured patients, limiting it in those with uncontrolled bleeding (MAP of 65 mmHg, SBP of 80 mmHg) to minimize blood loss.
For hypotensive patients with potential traumatic brain injury, maintain normal blood pressure (MAP of 85 mmHg, SBP of 110 mmHg).

Administer tranexamic acid (1 g) for hemorrhagic shock; consider fibrinogen for uncontrollable bleeding.

Utilize intraosseous access when intravenous access fails.

Review by Hussmann B, Hilbert-Carius P (…) Maegele M et 7 al. in Eur J Trauma Emerg Surg

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