Emergency care for trauma patients in the red zone: clinical experience from 2024

Abstract

Background. The traumatized patient with signs of shock remains a major cause of morbidity and mortality, requiring rapid diagnosis and multidisciplinary management. This study evaluates clinical, paraclinical, and therapeutic aspects of trauma patients admitted with shock signs in the red zone of the Emergency Department of the Institute of Emergency Medicine during 2024. Material and methods. A prospective analysis of 60 polytrauma patients in shock was performed. Demographic data, trauma mechanisms, Glasgow Coma Score, vital signs, imaging, emergency interventions, and outcomes were evaluated. The patients were managed according to an experimental protocol developed at the institutional level, which provides for a multidisciplinary approach to the traumatized patient. This protocol was developed based on the international protocol for Advanced Trauma Life Support. It will later be implemented at the institutional level. Results. The cohort included 79% males, with a mean age of 49.7 ± 15.2 years; 75% urban residents. Grade III and IV shock were diagnosed in 40% and 28.3%, respectively. Causes of trauma included physical aggression (29.5%), road traffic accidents (28.5%), and accidental trauma (21.0%), falls from height (21.0%). Radiological lesions were detected in 63.3%, positive findings on Focused Assessment with Sonography for Trauma in 40%, and cranial lesions identified by computed tomography in 60%. Intraglotic intubation was required in 80% of patients, vasopressor support was administered in 50%, antibiotic therapy in 95%, and emergency surgery was performed in 30%. Mortality was 1.7%. Conclusions. Protocol-driven multidisciplinary care facilitated effective stabilization of traumatized patients presenting with shock. Early diagnosis, the use of advanced imaging techniques, and timely therapeutic interventions significantly contributed to improved patient outcomes. These findings underscore the critical role of structured trauma life support protocols in emergency medical settings.