Việc quản lý của các bệnh nhân bị thương là nhân Thách thức cho các bác sĩ lâm sàng Ngay cả kinh nghiệm. Bởi vì đã dành nhiều Thiếu Cộng đồng đội chấn thương Bệnh viện, Nó thường là bác sĩ phẫu thuật chỉnh hình Ai sẽ trực tiếp điều trị. Do, các bác sĩ phẫu thuật chỉnh hình phải có một hiểu biết về hướng dẫn cho việc hồi sức thành lập | App roach to the Polytraumatized Patient With Musculoskeletal Injuries Clifford H. Turen MD Michael A. Dube MD and C. Michael LeCroy MD Abstract The management of the multiply injured patient is a challenge for even experienced clinicians. Because many community hospitals lack a dedicated trauma team it is often the orthopaedic surgeon who will direct treatment. Therefore the orthopaedic surgeon must have an understanding of established guidelines for the evaluation resuscitation and care of the severely injured patient. Initial evaluation encompasses assessment and intervention for airway breathing circulation disability neurologic injury and environmental and exposure considerations. Resuscitation requires not only administration of fluids blood and blood products but also emergent management of pelvic trauma and stabilization of long-bone fractures. Judicious early use of anterior pelvic external fixation can be lifesaving in many cases. The secondary survey which is often neglected must incorporate a thorough physical evaluation. Although the method of fracture stabilization is still controversial most clinicians agree that early fixation offers many benefits including early mobilization improved pulmonary toilet decreased cardiovascular risk and improved psychological wellbeing. Without an understanding of the complexities of the multiply injured patient delays in the diagnosis and treatment of a patientÕs injuries are likely to adversely affect outcome. J Am Acad Orthop Surg 1999 7 154-165 In a level I trauma center it is usually the trauma-trained general surgeon who is the leader of the multidisciplinary trauma team caring for the severely injured patient and the orthopaedic surgeon functions as a member of that team. In many community hospitals a general surgeon is often in charge of the overall management of the trauma patient but the orthopaedic surgeon plays an important role and may at times serve as the leader. Therefore it is incumbent on the .
