Acute management
EMST / ATLS Principles
Usually polytrauma
- 10% mortality
Aims
1. Volume replacement
2. Reduce pelvic ring
3. Stop exsanguination
- external stabilisation / surgery / embolisation
Associated Local Injuries
Arterial bleeders

Usually polytrauma
- 10% mortality
Aims
1. Volume replacement
2. Reduce pelvic ring
3. Stop exsanguination
- external stabilisation / surgery / embolisation
Arterial bleeders

Usually young patients
- 15 - 40
15% compound
High velocity injury
- MBA
- MVA
- pedestrian v car
- fall from height
EMST principles
- need for transfusion not uncommon
Trauma is 3rd most common cause death in all age groups
- number one in young adults < 44 years
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