Initial Treatment of Patients with Extensive Trauma

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Abstract
PATIENTS with life-threatening injuries make up approximately 10 to 15 percent of all patients hospitalized because of injuries.1 Some authors have defined patients with extensive trauma as those with injury severity scores (ISSs) higher than 15 (for an explanation of the ISS see the Appendix).2 3 4 That is an acceptable definition for purposes of triage, but in this discussion I shall define extensive trauma as indicated by an ISS above 25. Most patients in this category have multisystem trauma. Deforming and destructive injuries can be obvious, but the surgeon or physician who initially treats the patient must promptly conduct a systematic . . .

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