الفهرس 
Fluid ReplacementOnly 14 pages are availabe for public view
 |  | from | 121 |  |  |
| | | from | 121 | | |
Abstract
Trauma is the commonest cause of death in the first four decades of life, and still, it‟s a major health problem in all countries, while damage in Egypt is several times higher due to under-reporting and misclassification. (Yadollahi et al, 2019). Classically, mortality secondary to trauma is described as having a trimodal distribution. The first peak occurs in the first seconds to minutes following trauma due to fatal injuries. The second one occurs minutes to several hours after, resulting in serious, potentially fatal injuries if there is no intensive care. Finally, the third peak occurs several days to weeks after trauma, due to complications such as sepsis and multiple organ failure (Mahran et al, 2013). The trauma first mortality peak is due to serious and often fatal injuries, and only prevention can be applied in its reduction. The second peak is due to potentially fatal injuries, such as subdural and epidural hematoma, hemopneumothorax, splenic rupture or liver lacerations. Mortality in these cases can be reduced with early diagnosis of injuries due to their rapid resolution (O’Keeffe et al, 2016). This is where the trauma scores should be used for a streamlined and effective approach to the trauma victims. Many tools for the polytrauma care exist for better management of these patients, as well as to provide predictive factors of morbidity and mortality in order to generate statistical data for the establishment of preventive measures to trauma (American College of Surgeons ATLS 2016). Introduction 2 Some of these tools are the trauma scores, which are mathematical or statistical values, quantified by numerical scores, which vary according to the severity of injuries resulting from trauma, and help the professional in the care of the injured trauma patients, especially in the prehospital environment and initial treatment in the emergency room (Oyeniyi et al, 2017). There are several trauma scores, with different levels of complexity for practical implementation. The Revised Trauma Score (RTS) is widely used by emergency services around the world. It is classified as physiological, since it takes into account parameters of the patient’s vital functions. This is an improvement of Trauma Score (TS), created in 1981, but without the assessment of capillary refill and respiratory effort (Rossaint et al, 2016).