Gestione del traumatizzato cranico: Strategie di soccorso nella fase preospedaliera

Prehospital head trauma care may be critical for the patient's subsequent prognosis of the patient. Hypoxia and hypotension with secondary brain damage may derive from mistakes in the treatment priorities. In a consecutive series of 121 deceased multiple trauma patients where the autoptic evaluation revealed head trauma as the major cause of death, it as demonstrated that death occurred mainly during the prehospital care, on the scene or during transportation. Categorization of central nervous and non- central nervous lesions using the Abbreviated Injury Scale, it has shown that many patients died with AIS grade 4 or sometimes 3 injuries, meaning that some of these deaths may be potentially preventable. Physiologic alterations consequent to head trauma or associated extracranial injuries seem to be the most important cause of these deaths. Strategies of prehospital trauma care must include the possibility to treat cardiorespiratory instability at least by means of airway and breathing and hemorrhage control and intravenous fluid infusions, according to modern guidelines of Advanced Trauma Life Support.