NURSING INTERVENTIONS FOR PATIENTS WITH MULTIPLE TRAUMA IN INITIAL CARE IN THE EMERGENCY DEPARTMENT. A SYSTEMATIC REVIEW

Abstract

DOI: https://doi.org/10.46296/yc.v10i18.0851

Abstract

Objective: To synthesize the available evidence on priority nursing interventions during the initial care of patients with multiple trauma in the emergency department. Methods: Documentary systematic review, adapted from the original thesis, following PRISMA 2020 principles and critically appraised with the Johns Hopkins Nursing Evidence-Based Practice model. PubMed/MEDLINE, CINAHL, LILACS, SciELO, Embase, ScienceDirect, and Google Scholar were searched. Studies published within the last five years in Spanish, English, and Portuguese and focused on nursing interventions in the initial phase of multiple trauma care were included. Results: Thirty-six studies were included. The evidence showed that interventions were predominantly organized around the XABCDE approach, with the strongest support for early hemorrhage control, airway protection, ventilatory and neurological monitoring, timely trauma team activation, and prevention of complications related to hypothermia, coagulopathy, and hypoperfusion. The most consistent measures included early tranexamic acid administration, preparation for massive transfusion, fluid warming, normocapnia monitoring through EtCO2, and serial neurological reassessment. Conclusions: Nurses play a decisive role in survival and early stabilization of polytrauma patients. The XABCDE protocol emerged as the most robust framework to organize clinical priorities, although operational gaps and methodological heterogeneity remain, supporting the need for continued training and applied research.

Keywords: Polytrauma; emergency nursing; initial management; XABCDE; resuscitation; systematic review.