Trauma and shock: priority actions in the red zone of the Emergency Department

Abstract

Background. Shock in the trauma patient remains one of the most life-threatening medical emergencies, requiring rapid identification, complex intervention, and interdisciplinary coordination. Without effective treatment, shock can rapidly lead to multiorgan failure and death. Prompt clinical management is essential. Objective(s). Evaluation of the clinical and paraclinical profile of the therapeutic strategy applied to traumatized patients in shock in the red zone of the Emergency Department (ED) during 2024. Materials and methods. A prospective, analytical-descriptive study was conducted during 2024 within the ED of the Institute of Emergency Medicine (IEM). The research group included 60 traumatized subjects with signs of shock, treated in the red zone. Demographic data, trauma mechanism, vital parameters and applied therapeutic interventions were statistically analyzed. Results. Of the 60 patients included, 79% were male and 21% female, with a mean age of 49,7 ± 15,2 years. Grade III shock was diagnosed in 40% and grade IV in 28,3%. Main trauma causes were physical aggression 29,5%, road traffic accidents 28,5%, and accidental trauma 21%. All patients were assessed clinically and paraclinically using the ABCDE protocol. Radiological lesions were detected in 63,3% of cases, a positive FAST exam in 40%, and CT revealed intracranial lesions in 60%. Infraglottic intubation was performed in 80%, vasopressors given to 50%, antibiotics to 95%, and 30% needed emergency surgery. Mortality was 1,7%. Conclusion(s). Shock in traumatized patients demands a multidisciplinary, protocol-based approach. The effective management in the red zone of the ED at IEM, guided by the ABCDE principle, led to timely interventions, accurate diagnosis, and a low mortality rate of 1,7%, highlighting the system’s efficiency.