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Introduction: Trauma and Traumatic injuries account for about 38% of the weight of surgical diseases and affect in most cases, young people. [1] In the USA trauma ranked fifth as the cause of death throughout the population and is the leading cause of death at age < 44 years.

The majority of preventable hospital deaths from trauma are due to uncontrollable bleeding and the result of the development of the "Lethal Triad" [2].

The technique of Damage control surgery (DCS) has been continuously developing during the treatment of trauma civilians and military during the wars of Napoleon, this technique is closely related to the history of military medicine [3].

The concept of Staged Laparotomy is to help stop the bleeding primary was described in 1908 by Pringle [6]. Halsted & Schroeder individually reported on their success in stopping the bleeding in trauma heparin through its packaging. In 1913 Halsted technique described packaging modifications liver (PH) [6].

The origin of DC was in World War II, which was described by the US Navy as a strategy to salvage the "Vessels Damaged" [8, 9], which consisted of a method to avoid repairing the final immediate injuries to the big vessels and focus only on the preservation of what was needed, restoring the ship [the patient (Pt)] in the secure "harbor" (while maintaining without permeability of water and motor power) to do after in the second stage any definitive repairs.

DCS is defined as the initial fast control of bleeding and contamination. He recommended temporizing patients with abdominal packing and temporary closure to allow restoration of normal physiology prior to returning to the operating room for definitive repair. 

Our goal is to provide a scheme DCS, its indications

Its core concepts are relatively uncomplicated and simple in nature and incorporate.

1-    To appropriate identification of the patient who is in need of following this model;

2-    To realize as soon as possible the initial surgical procedure to the minimum necessary operation;

3-    To permit the aggressive and focused resuscitation in the intensive care unit;

4-    To perform the definitive care only once the patient is optimized to tolerate the procedure.

To illustrate theoretical data we have described the case report with a gunshot wound and discussion of management tactics step by step at all levels of his treatment

Keywords; Lethal triad, abdominal trauma, surgical control of damages, Laparotomy, hypothermia, metabolic acidosis….

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Traffic movements is one of the most economical activities of modern people. Traffic medicine is an interdisciplinary field that has medicine, psychology, research and accident and vehicle type, it includes all those activities aimed at reducing harm from traffic crashes. Worldwide, 1.35 million people die each year, with 3,700 people dying globally every day, road traffic injury will continue is required to have the fifth cause of death by 2030.

In road traffic accidents involving vehicles, buses, motorcycles, bicycles, trucks or pedestrians, and more than half of the others injured their feet, motorcyclists and cyclists.

Traffic medicine as terminology has been used for 40 years by the International Association for Traffic Accident Medicine founded in 1960 in San Remo, Italy.

Traffic medicine has found all those activities that aim to reduce traffic collision injuries and is a big part of worldwide public health and whitewashed traffic accidents as the leading causes of deaths of victims in road traffic accidents and accompanied by severe social and economic consequences.

World Road Safety Day was marked on April 7, 2004 when hundreds of associations organized events to raise awareness and damage to road traffic as a global health problem.

Mobilizing the government and other institutions, civil society has aimed to damage traffic, invalidity and mortality in road accidents. The government will implement stricter measures to reduce road traffic injuries through health promotion campaigns, consolidating the injury monitoring system and mobilizing various sectors at all levels of society.

The governments of most countries welcome the report of the WHO, the World Bank on the prevention of road traffic injuries, while respecting the implementation of the requirements in the previously visible measure.

Road accidents understood one of the three major public health problems in every country of the world. This worrying global issue, we are very aware of the fact that the effective and mandatory prevention of injuries and deaths in road traffic can only manage to enable multisectoral coordination.

The lack of an infrastructure to be included in our city, along with me or the lack of a regulated regulatory framework, made it even more demanding exponentially the number of accidents in road traffic.

In this way, we are aware that a campaign should be involved not only in public and education, but also as strict law enforcement measures.

After all, transportation is increasingly associated with road accidents and premature deaths, the invalidity of physics and psychology, but so significant is the increase in the cost of health care services and the burden of public funding, and the development of the situation of also made more by rapid and unplanned urbanization. In order to prevent the incidence and fatal road accidents in the country, it is what professionals care about citizens to know how to provide first aid, basic care, how to treat a victim of road accident at the scene With Recognition of first aid and basic care basics would certainly like a time purchase to save the lives of victims in accidents and road traffic.

Keywords; Traffic medicine, Road accidents, Trauma, Management, EMS,  Medical Services, PHTLS, ATLS

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Hyrje: Sir William Osler* citon: “Ai që studion mjekësi pa libra, lundron në një det të paeksploruar”  Osler mbrojti rëndësinë e sigurimit të korrelacioneve klinike në mësimin e siguruar nga librat dhe ushtrimin e tyre në praktikë. Vitet e fundit të gjitha shkollat mjekësore kanë kuptuar rëndësinë e korrelacioneve teoriko-praktike dhe edukimi është bërë shumë më i bazuar në problemet e urgjencës mjekësore, duke përdorur rastet e simuluar dhe prezantimet e tyre.

Shumica e shkollave mjekësore në Shtetet e Bashkuara kanë rritur ndërveprimet me pacientët, edhe për studentët e vitit të parë dhe të dytë të mjekësisë. Sidoqoftë, autorët dhe redaktorët e librave shkollorë kanë qenë shumë më të ngadaltë për t’u përshtatur me këtë ndryshim. Shumica e librave shkollorë mjekësorë, përfshirë edhe ato në specialitetin e mjekësisë së urgjencës, mbeten të orientuar nga sëmundjet, sesa te pacientët.  Si rezultat, shumica e librave shkollorë zënë pozicione të dukshme në raftet me pluhur të librave të përdorura rrallë.

Libri “Mbështetja bazike jetësore dhe defibrilimi”, botimi i parë, paraqet teknikat bazë të mjekësisë së urgjencës, duke avancuar më tepër, për të rritur fashën e lexuesve dhe të të interesuarve për këtë libër.

Një tjetër forcë e dukshme e librit është shpjegimi me imazhe i të gjitha procedurave, të cilat janë prezente në të gjithë tekstin. Në përgjithësi, studentët, ofruesit e nivelit të mesëm dhe mjekët me përvojë të urgjencës do ta konsiderojnë këtë libër të dobishëm për përmirësimin e praktikës së tyre klinike dhe praktike me njohuri bazë për dhënien e ndihmës së parë dhe jo vetëm...

Besojmë se ky botim do të bëhet një vlerë e shtuar në literaturën e mjekësisë së urgjencës. Studentët dhe klinicistët do ta shohin këtë botim unik dhe praktik, të lehtë për ta lexuar dhe kuptuar. Shpresa jonë e sinqertë është që ky tekst të shërbejë si model për lexuesit në lidhje me rëndësinë dhe menaxhimin e urgjencës mjekësore në nivel praktik.

Fjaletkyqe: mjekesia e trafikut, aksidentet rrugore, Trauma, Manaxhimi i traumave, ShUM, shërbimi urgjencës, PHTLS, ATLS kurs