Update on prehospital care of multiple trauma patients

Together with 25 specialist societies and professional associations, the German Society for Trauma Surgery ("Deutsche Gesellschaft fur Unfallchirurgie", DGU) revised the S3 guideline on treatment of multi systeme trauma and severe injuries. The aim of this article is to present the most important developments in prehospital trauma care using a case study and to assign the measures taken to the corresponding recommendations of the guideline. With the current revision, a separate chapter "Stop the bleed" for the prehospital phase was introduced into the guideline. Hemodynamically and mechanically unstable pelvic ring injuries can be life-threatening for the patient due to exsanguination. Therefore, the stability of the pelvis should be carefully assessed in the prehospital setting. In multi systeme trauma patients, severe hypoxemia can rapidly occur. This should be managed by induction of emergency anesthesia, followed by airway management and ventilation. Aspects regarding analgesia in trauma patients can be found in the chapter "Analgesia". Since patient safety is paramount, the guideline points to the need for regular training in emergency anesthesia and airway management, including use of all alternative devices and techniques for airway management.