After an attack, many victims are brought to the admitting area over a period of minutes either by qualified pre-hospital personnell or, in many cases, bystanders. Triage at the hospital is of utmost importance in these scenarios. A trauma-qualified senior general surgeon should perform triage and direct personnel and victims.
The authors suggest: "As in all trauma cases, airway control and acute breathing problems are prioritized. In our experience, over-triage and over-treatment of acute respiratory problems in these frenetic situations is favored. A delay in intubation and in placement of thoracic drains will compromise outcome.
Hypotensive victims of penetrating abdominal or thoracic trauma are rushed to the operating room for laparotomy and/or thoracotomy. This approach stems from our understanding that the mechanism of hypotension is major intraobdominal and/or intrathoracic bleeding. Hypotensive victims with abdominal and/or thoracic injuries believed to contribute significantly to their instability should also be rushed to the operating room. Laparatomy and thoracotomy, however, should be delayed in exceptional instances.
Multiple entry sites, which are common in these victims, are associated with extensive soft-tissue damage. Since the attacker usually approaches his victims from behind, the majority of entry sites are located on the back of the victims´ bodies. Positioning the patient in the supine position and performing routine abbreviated laparotomy may actually postpone treatment of these potentially more serious injuries ..."