Hemorrhagic Shock and Early Resuscitation: the Pros

SUMMARY Management of trauma patients with hemorrhagic shock in the prehospital setting remains a particularly controversial issue, with opposing approaches used in North America and Europe. The United States, served by emergency medical technicians and paramedics, is based on the “scoop and run‘ approach. The opposite is the case in European countries, where the prehospital teams usually include qualified physicians who can provide sophisticated prehospital care adapted to each patient (the “stay and play” approach). Even if there is controversy about prehospital volume loading in patients with penetrating injuries to the torso, in most cases of trauma patients with hemorrhagic shock, efficient airway control, early mechanical ventilation, prehospital chest tube thoracostomy (in the case of tension pneumothorax) and prehospital volume loading performed by a specialized team with prehospital and in‐hospital experience have been clearly demonstrated to improve patient prognosis. Moreover, physicians on the scene provide not only advanced life support but also analgesia, anesthesia, first diagnosis of injuries and orders for appropriate hospital admissions.