ABC to &lt;C&gt;ABC: redefining the military trauma paradigm

Hodgetts, Tim; Mahoney, Peter F.; Russell, MQ; Byers, Mark

doi:10.1136/emj.2006.039610

Cited by 210 publications

(113 citation statements)

References 9 publications

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“…C<>ABC is practised with the initial priority being to stop life-threatening (Catastrophic) haemorrhage first. 15 Surgical treatment of a traumatic amputation is the same as any military wounds. Debridement is carried out to excise all necrotic and foreign material and the wound should not be closed primarily.…”

Section: Managementmentioning

confidence: 99%

Traumatic amputations

Clasper

Ramasamy

2013

British Journal of Pain

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Traumatic amputations remain one of the most emotionally disturbing wounds of conflict, as demonstrated by their frequent use in films to illustrate the horrors of war. Unfortunately, they remain common injuries, particularly following explosions, and, in addition, many survivors require primary amputation for unsalvageable injuries or to save their life. A third group, late amputations, is being increasingly recognised, often as a result of the sequelae of complex foot injuries. This article will look at the epidemiology of these injuries and their acute management, complications and outcome. KeywordsAcute pain, chronic pain, musculoskeletal pain, neuralgia, pain Key pointsTraumatic amputation remains very common following combat or terrorist wounding. With the significant advances in resuscitation, proximal and multiple amputations are being increasingly seen in survivors. As a result of the effects of the explosion, considerable tissue trauma occurs. Nerve injury is common and, with time, the functional level of the amputee will fall. These injuries remain a significant problem to health services following wars.

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Section: Managementmentioning

confidence: 99%

Traumatic amputations

Clasper

Ramasamy

2013

British Journal of Pain

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“…Control of catastrophic haemorrhage is the priority in trauma, as exemplified by the emphasis placed on it in the modified <C>ABC algorithm, 4 and is germane to prevention of immediate exsanguination, and emerging interacting sequelae of coagulopathy, hypothermia and acidosis (the 'lethal triad'). 5 Evidence of haemorrhage can be extracted using the MIST (Mechanism, Injuries sustained, vital Signs and Treatment given) history format, clinical examination and, to a lesser extent, from vital signs, which have been shown to be unhelpful in isolation, 6,7 but suggestive in combination.…”

Section: Haemorrhage Diagnosismentioning

confidence: 99%

Damage control – trauma care in the first hour and beyond: a clinical review of relevant developments in the field of trauma care

Sharrock

Midwinter

2013

annals

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INTRODUCTION Trauma provision in the UK is a topic of interest. Regional trauma networks and centres are evolving and research is blossoming, but what bearing does all this have on the care that is delivered to the individual patient? This article aims to provide an overview of key research concepts in the field of trauma care, to guide the clinician in decision making in the management of major trauma. METHODS The Ovid MEDLINE ®, EMBASE™ and PubMed databases were used to search for relevant articles on haemorrhage control, damage control resuscitation and its exceptions, massive transfusion protocols, prevention and correction of coagulopathy, acidosis and hypothermia, and damage-control surgery. FINDINGS A wealth of research is available and a broad range has been reviewed to summarise significant developments in trauma care. Research has been categorised into disciplines and it is hoped that by considering each, a tailored management plan for the individual trauma patient will evolve, potentially improving patient outcome.

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“…This should be followed by the prompt transfer of the patient to a trauma centre [8] for more advanced assessment of injuries including the use of imaging techniques followed by appropriate surgical management of the wounds. However in military settings, where haemorrhage from extremity wounds arising from ballistic and blast injuries is a major concern, some authors advocate a modified management sequence proposing that the ABC sequence of resuscitation be replaced by <C>ABC, where <C> emphasizes the control of catastrophic haemorrhage [45].…”

Section: Pre-hospital Managementmentioning

confidence: 99%