EMST

Management Acute

EMST / ATLS PrinciplesPelvic Fracture APC

 

Usually polytrauma

- 10% mortality

 

Aims

1. Volume replacement

2. Reduce pelvic ring

3. Stop exsanguination

- external stabilisation / surgery / embolisation

 

Associated Local Injuries

 

Arterial bleeders

Femoral Shaft Fractures

Epidemiology

 

Usually young patients

- 15 - 40

 

15% compound

 

Aetiology

 

High velocity injury

- MBA

- MVA

- pedestrian v car

- fall from height

 

Emergency Managment

 

EMST principles

- need for transfusion not uncommon

- hypotension from isolated closed femoral fracture unlikely

EMST / ATLS

Background

 

Trauma is 3rd most common cause death in all age groups

- number one in young adults < 44 years


Death

 

Death occurs in 3 time periods

 

1.  First few minutes

- death secondary aortic rupture or severe head injury

- 50% die in this period

- only a few survive 

- only if rapid transport 

 

2. Golden Hour 

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