Skip to main content
Fig. 1 | World Journal of Emergency Surgery

Fig. 1

From: First clinical experiences of concurrent bleeding control and intracranial pressure monitoring using a hybrid emergency room system in patients with multiple injuries

Fig. 1

Photographs of the concurrent treatments performed using the HERS. a All doctors and nurses wear radiation protection products before patients’ arrival. Patients are directly accommodated in the hybrid emergency room on arrival. Chest X-ray, pelvic X-ray, and FAST are not performed routinely preceding CT scanning. b After intravenous access is achieved, whole-body CT examination is performed as soon as possible. Head and neck CT are routinely performed without contrast and chest, abdominal, and pelvic CT with contrast. The gantry of the CT scanner moves instead of the patients’ table during CT scanning. c A REBOA catheter is inserted with fluoroscopic guidance to avoid complications. The balloon inflation volume is controlled to maintain a systolic BP of 90–100 mmHg before ICP measurement and to preserve a CPP ≥ 60 mmHg after ICP monitoring. d Bleeding control procedures and ICP monitoring and/or ventriculostomy are performed simultaneously if active torso bleeding and significant intracranial lesion are detected by CT. Neurosurgeons make sure not to interfere with surgical procedures and IR since priority is always given to hemostasis. BP, blood pressure; CPP, cerebral perfusion pressure; CT, computed tomography; FAST, focused assessment with sonography for trauma; HERS, hybrid emergency room system; ICP, intracranial pressure; IR, interventional radiology; REBOA, resuscitative endovascular balloon occlusion of the aorta

Back to article page