Algorithm for management of Multiple Trauma in Mountain Environment Complete primary survey - Haemorrhage control (regional and systemic, e.g. pelvic binder, compression, haemostatic agents, antifibrinolytics-TXA, desmopressin) - A - Airway management, intubation/supraglottic devices - B - Ventilatory support, decompression of pneumothorax - C - Circulatory support: fluids, vasopressors (norepinephrine), transfusion - D - Central nervous system (GCS, AVPU) and extremities - E - Exposure only if safe, protection from environment Secondary survey - Physical examination head to toe, front and back - Consider history, injury mechanism (e.g. long fall, high impact injury) Complete patient management - Analgesia, splinting and immobilisation (vacuum mattress), SMR - Consider POCUS - Prevent hypothermia (e.g. insulation, heat packs) - Minimise prehospital time doi: 10.1186/s13049-020-00790-1 #Multiple #Trauma #Mountain #Environment #Algorithm #management #wilderness
