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November 1957

Priority of Treatment in Multiple Injuries and Summation of Surgery for Acute Trauma

Author Affiliations

U. S. Army

AMA Arch Surg. 1957;75(5):743-745. doi:10.1001/archsurg.1957.01280170053033

When speaking of priority of treatment, one usually thinks of many casualties and of the necessity for deciding which patient needs immediate care. Here, we are not speaking of mass casualties, but we refer to multiple injuries in one patient and of the necessity to decide which type of injury requires care the most urgently. From a consideration of the frequency with which various body regions are wounded, it is apparent that, aside from hemorrhage, at least 50% of injuries carry no immediate threat to life. The distribution is shown in the accompanying Table.

Obviously, those wounds which hinder cardiorespiratory function, such as chest, neck, and maxillofacial injuries, must be managed very early, and those wounds in which there is severe external hemorrhage require equally early care. It is a matter of nice judgment as to which is to be corrected first in the individual case. In only these two

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