Chinese expert consensus on the prehospital management of major trauma（2026）梅斯医学M...

中文题名：2026 中国专家共识：严重创伤的院前管理（严重创伤院前急救中国专家共识） 发表期刊：Chinese Journal of Traumatology，Volume 29, Issue 2, Mar 1, 2026；在线发表：2026‑02‑13 发布机构：中华医学会创伤学分会创伤急救与多发伤学组、中华医学会灾难医学分会青年学组、陆军医院战创伤救治专科联盟 DOI：10.1016/j.cjtee.2026.01.002 作者：Yang Li, Liangjun Lang, Jiliang Zhang, et al., Lianyang Zhang (corresponding author)

摘要（Abstract）

To standardize the key techniques and protocols of pre‑hospital emergency care for major trauma in China, and to improve the quality and efficiency of treatment, a multidisciplinary panel of experts in emergency medicine, trauma care, and pre‑hospital rescue was organized to form an expert committee and a core working group. The group systematically searched databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI and CBM to collect relevant guidelines, systematic reviews and clinical studies. After multiple rounds of consultation, voting and consensus meetings to resolve disputed items, 16 recommendations were formulated addressing 14 core clinical questions in the pre‑hospital management of major trauma. The contents cover scene safety, rapid recognition and early warning of major trauma, control of catastrophic external hemorrhage (X), airway management (A), breathing management (B), circulation management (C), disability/neurologic assessment (D), exposure and temperature control (E), geriatric trauma, immobilization and extrication, transport decision‑making, pre‑hospital‑to‑hospital handover, teamwork, and systematic training. This consensus highlights the xABCDE assessment sequence. Key interventions are recommended: commercial tourniquets and wound packing for hemorrhage control, permissive hypotensive resuscitation, early administration of tranexamic acid, and standardized pelvic binder application. A standardized information framework is advocated for handover between pre‑hospital and in‑hospital teams. This consensus provides evidence‑based, operable protocols for front‑line pre‑hospital providers, promotes homogenization of major trauma pre‑hospital care across China and helps optimize patient outcomes.

Key words: major trauma; pre‑hospital emergency care; xABCDE; expert consensus; trauma care system

核心框架（14 个临床问题，16 条推荐）

1. 现场安全 Scene safety
2. 严重创伤快速识别与预警 Rapid recognition & early warning of major trauma
3. 灾难性外出血控制（X）Control of catastrophic external hemorrhage（X）
4. 气道管理（A）Airway management（A）
5. 呼吸管理（B）Breathing management（B）
6. 循环管理（C）Circulation management（C）‑允许性低血压复苏、氨甲环酸、骨盆固定带
7. 神经功能评估（D）Disability /neurologic assessment（D，GCS）
8. 暴露与体温管理（E）Exposure & temperature control（E，预防低体温）
9. 老年特殊创伤 Geriatric trauma
10. 固定与搬运 Immobilization and extrication
11. 转运决策 Transport decision‑making
12. 院前‑院内交接 Pre‑hospital‑to‑hospital handover（标准化信息传递）
13. 团队协作 Teamwork
14. 系统化培训 Systematic training

核心亮点：将致命外出血 X 放在评估流程首位，确立xABCDE流程，替代传统 ABCDE，优先控制可致死的外出血。