Interdisciplinary care in emergency clinics. Interdisciplinary emergency room management

In major trauma it is essential to recognize immediately and treat adequately life-threatening problems and conditions. Emergency room (ER) management means time management: Besides optimization of infrastructure by implementing digital techniques, particularly focused assessment with sonography in trauma (FAST) and multislice computed tomography (MSCT), predefined protocols and algorithms are key elements of interdisciplinary ER management. According to our Advanced Trauma and Life Support based trauma algorithm, a multidetector scanner in the emergency department is utilized immediately after the correction of respiratory problems, to detect causes of bleeding or intracranial injury. During trauma resuscitation, contrast-enhanced MSCT reveals data essential for critical decisions, complete identification of life-threatening problems, and relevant support for termination of treatment. Comprehensive ER management thus implies an algorithm-guided, coordinated team approach with early integration of FAST and focused assessment with computed tomography in trauma (FACTT). New approaches in ER management implement standard operation procedures based on function derived less from the specialty per se (i.e. trauma surgery, anaesthesiology, radiology) than from interdisciplinary management of airway, respiratory, and circulatory problems.