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It is generally understood that the first aim in the practice of surgery and medicine is to get the patient through an ordeal alive, at all times keeping him at the greatest possible distance from the possibility of death. From the surgical standpoint this aim is achieved when the patient arrives at the hospital as a good risk. Yet often the traumatic patient arrives at the hospital in extreme shock, even irreversible shock, when if adequate first aid had been given promptly after injury he would have arrived at the hospital in good physical condition. For example, a patient arrives practically exsanguinated by profuse hemorrhage from an otherwise minor wound, the hemorrhage from which could have been readily controlled by a compression dressing. Similar mischances are usual in all forms of injuries whether they are surface wounds involving extensive areas of the body, crushing injuries of moderate areas or severed
GALLAGHER JL. DEFINITIVE TREATMENT OF SEVERE WOUNDS: LARGE SURFACE TO SMALL AREA. JAMA. 1943;123(11):675–680. doi:10.1001/jama.1943.02840460009003
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