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Pitfalls in the management of the trauma patient in the intensive care unit

Department of Surgery, Division of Trauma, University of California, San Diego, San Diego, California, USA

Raul Coimbra

Department of Surgery, Division of Trauma, University of California, San Diego, San Diego, California, USA

David B Hoyt

Department of Surgery, Division of Trauma, University of California, San Diego, San Diego, California, USA, dhoyt{at}ucsd.edu

The management of the critically injured patient in the intensive care unit is the focus of this paper, in particular, the pitfalls attendant in the diagnosis and treatment of specific injuries. The past two decades have seen great advances in the care of the injured patient, both in the prehospital triage and transport and in the intensive care unit. More than ever, the outcome of these patients, both in terms of morbidity and mortality, is very dependent on a solid understanding of the pathophysiology of certain disease states and also of the evolution of certain injuries. Attention to detail is critical and an awareness of the pitfalls is essential, if one is to be successful in avoiding preventable morbidity and mortality. This article addresses pitfalls in judgement and also in specific management of specific injury patterns that will aid in better management of the severely injured patient.

Key Words: trauma • missed injuries • pitfalls • intensive care • hypotension • head injury • sepsis • hypoxemia

Trauma, Vol. 1, No. 4, 301-312 (1999)
DOI: 10.1177/146040869900100405


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