Manejo extrahospitalario avanzado de pacientes con hemorragia no compresible tras un traumatismo penetrante

Los pilares básicos del tratamiento de los pacientes con heridas con hemorragia no compresible tras un traumatismo penetrante son el control precoz de la hemorragia y el traslado urgente a un centro útil. Las guías 2021 del European Resuscitation Council incluyen, en la atención a la parada cardiaca traumática, otras técnicas: la transfusión de productos sanguíneos in situ, la toracotomía resucitativa y la oclusión resucitativa de la aorta con un balón endovascular. No obstante, no hay guías claras sobre cómo desarrollar su uso en en entorno prehospitalario. Este artículo revisa la evidencia que apoya su uso y la experiencia de diversos SEM con helicópteros europeos para evaluar su utilidad, y aporta algunas ideas sobre cómo extender el uso de estas medidas. Puedes descargarte el artículo aquí: https://drive.google.com/file/d/1v-L4JxCWUkox6WV2_p0dUnQlRLgZkASq/view?usp=sharing

Early haemorrhage control and minimizing the time to definitive care have long been the cornerstones of therapy for patients exsanguinating from non-compressible haemorrhage (NCH) after penetrating injuries, as only basic treatment could be provided on scene. However, more recently, advanced on-scene treatments such as the transfusion of blood products, resuscitative thoracotomy (RT) and resuscitative endovascular balloon occlusion of the aorta (REBOA) have become available in a small number of pre-hospital critical care teams. Although these techniques are included in the current traumatic cardiac arrest algorithm of the European Resuscitation Council (ERC), published in 2021, clear guidance on its practical application in the pre-hospital setting is scarce. The paper web ring today provides a scoping review on how these advanced techniques can be incorporated into practice for the resuscitation of patients exsanguinating from NCH after penetrating injuries, based on available literature and the collective experience of several helicopter emergency medical services (HEMS) across Europe who have introduced these advanced resuscitation interventions into routine practice. Download link: https://drive.google.com/file/d/1v-L4JxCWUkox6WV2_p0dUnQlRLgZkASq/view?usp=sharing