Portal de Periódicos da CAPES

The Shock Index Revisited

1990; Springer Nature; Linguagem: Inglês

10.1007/978-3-642-84125-5_53

0933-6788

R. A. Little, D.F. Gorman, M Allgöwer,

Cardiac Arrest and Resuscitation

Trauma has been described as the last major plague of the young [1]. This is undoubtedly the case as injury is responsible for more deaths in those less than 44 years of age than, for example, heart disease and malignancies combined. Such a problem should ensure that the treatment of the injured, which has a history as long as that of surgery itself, would now be of the highest quality. That this is not the case was clearly demonstrated by Trunkey et al. in the U.S.A. They showed that as many as 73% of deaths following injury were preventable [2]. A very similar picture was revealed more recently in the U.K.[3]. This retrospective analysis of 1000 trauma deaths indicated that 63–71% of non-head and 29–37% of head injuries were preventable. An important factor in many of these deaths was a failure to recognize the presence and/or extent of blood loss. The inexperience of those first treating such patients may be part of the problem but limitations on the usefulness of the clinical signs of blood loss, an increase in heart rate and hypotension, may also be important.