Polytrauma Management and Links to EMS (original) (raw)
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Polytrauma – Definition Management Aspects and Trauma Score?
Albanian Journal of Trauma and Emergency Surgery
Introduction: It is defined as "a clinical condition by the action of an external agent causing profound physio-metabolic changes involving several systems simultaneously with life-threatening consequences." In Germany, more than 20 000 people die each year The main cause of M & M & D in childhood and adolescence Responsible for 80% of adolescent deaths Responsible for 60% of child deaths 73% of them caused by AA in the age group of 25-34 years Causes large and social loss -the country's economy Purpose; Discussion about polytrauma, principles, and their assessment at all levels; during the transport, in the Emergency Department, OR, ICU…Identifying the concepts of the Mortal triad, primary assessment, secondary evaluation ... and the primacy of concepts "Scoope and run" as the foundation of the concepts of ATLS... Examination of the pre-hospital management elements related to the time of the accident, the way of transport, transport time, etc ... the value o...
Comparative Study of Polytrauma Within a Group of 2004 Patients (Pediatrics and Young Adults)
The Annals of Dunarea de Jos University of Galati Fascicle XV Physical Education and Sport Management
Globally, there are many efforts to reduce the incidence of road accidents. However, the number of patients hospitalized with polytrauma is still high, with approximately 5.8 million deaths associated with traumatic injuries annually. Among the young, active age population, trauma is the current domain and timing a major cause of severe illness.Therefore we aimed by this study to evaluate comparatively the incidence of polytraumas among young adult patients presented in the Emergency - department (information obtained from the archive of the Emergency Clinical Hospital Sfântul Apostol Andrei Galați – 129 young patients) and pediatric subjects from a group of 710 children.The data obtained following the anamnesis, the clinical and paraclinical examination of the patients, were entered into the IBM SPSS Statistics 24 and Excel 2019, then sorted and filtered according to different criteria. In both groups, the incidence of male patients is statistically noticeable and also aspects rega...
The journal of trauma and acute care surgery, 2014
The nomenclature for patients with multiple injuries with high mortality rates is highly variable, and there is a lack of a uniform definition of the term polytrauma. A consensus process was therefore initiated by a panel of international experts with the goal of assessing an improved, database-supported definition for the polytraumatized patient. The consensus process involved the following: RESULTS: A total of 28,211 patients in the trauma registry met the inclusion criteria. The mean (SD) age of the study cohort was 42.9 (20.2) years (72% males, 28% females). The mean (SD) ISS was 30.5 (12.2), with an overall mortality rate of 18.7% (n = 5,277) and an incidence of 3% of penetrating injuries (n = 886). Five independent physiologic variables were identified, and their individual cutoff values were calculated based on a set mortality rate of 30%: hypotension (systolic blood pressure ≤ 90 mm Hg), level of consciousness (Glasgow Coma Scale [GCS] score ≤ 8), acidosis (base excess ≤ -6....
Epidemiology of Polytrauma in a Tertiary Care Centre
Journal of Evolution of Medical and Dental Sciences, 2016
Polytrauma is a major cause of morbidity and mortality in both developed and developing countries. The term "Polytrauma" is mainly used to describe blunt trauma patients whose injuries involve multiple body regions or cavities, compromise patient's physiology and potentially cause dysfunction of uninjured organs. This study about epidemiology of fractures in polytrauma patients was carried out in emergency of Orthopaedics Department, Government Medical College, Jammu. The study was done for a duration of one year. Data was collected related to age, sex, mode of injury, date, time of injury and admission, pattern of fractures, associated injuries as per in the standard protocol proforma. Then various mechanisms of trauma were correlated to the type of injuries, to define pattern of injuries encountered in various accidents in polytrauma victims and then analysis of data was done.
Injury, 2009
The management of patients with multiple injuries continues to be a challenging process. A critical evaluation of treatment results is impeded by a heterogeneous patient population, low number of cases and different therapy regimens over the past years. Recently, in an attempt to address these problems, several multi-centre databases of multiple trauma patients have been established and contributed to improvements in trauma care. Only rarely have studies been published from a single institution to review the changes over time in outcome of multiple trauma/ intensive care patients. Back in 1995, our group reported on 3406 multiple trauma patients treated at a single institution comparing two 10-year treatment periods. Epidemiological and demographic characteristics were described in detail as well as changes of the patient population and the effect of new achievements. 29 This study showed a considerable reduction of mortality as well as success in volume and ventilator therapy. 29 It was then suggested that an effort should be made to decrease rescue and resuscitation time for fast and effective therapy of traumatic shock. We also recommended early definitive stabilisation of long bone fractures and radical debridement of necrotic tissues to allow early restoration of physiological functions. We concluded that a further reduction of Injury, Int.
Risks in the Management of Polytrauma Patients: Clinical Insights
Orthopedic Research and Reviews
Polytrauma, a patient's condition with multiple injuries that involve multiple organs or systems, is the leading cause of mortality in young adults. Trauma-related injuries are a major public health concern due to their associated morbidity, high disability, associated death, and socioeconomic consequences. Management of polytrauma patients has evolved over the last few decades due to the development of trauma systems, improved pre-hospital assessment, transport and in-hospital care supported by complementary investigations. Recognising the mortality patterns in trauma has led to significant changes in the approach to managing these patients. A structured approach with application of advanced trauma life support (ATLS) algorithms and optimisation of care based on clinical and physiological parameters has led to the development of early appropriate care (EAC) guidelines to treat these patients, with subsequent improved outcomes in such patients. The journey of a polytrauma patient through the stages of pre-hospital care, emergency resuscitation, in-hospital stabilization and rehabilitation pathway can be associated with risks at any of these phases. We describe the various risks that can be anticipated during the management of polytrauma patients at different stages and provide clinical insights into early recognition and effective treatment of these to improve clinical outcomes.
Resuscitation of Polytrauma Patients - An Overview
Trauma is considered as the sixth leading cause of death worldwide, resulting in 10% of all deaths or five million died annually. It is the fifth leading cause of significant disability. About half of trauma deaths are in people aged between 15 and 45 years and is the leading cause of death in this age group. Mechanism of trauma can be classified as mechanical, physical and chemical according to the source of energy. Trauma induced hemorrhage accounts for the largest proportion of mortality within the first hour of trauma, Moreover, hemorrhageinduced hypotension in trauma patients is predictive of greater than 50% mortality. Assessment and resuscitation of Polytrauma patient begins before the event by prophylactic measurements, at the site of event, during transport (pre hospital phase 50% immediate death of patients) and in emergency room. Trauma care in the 1970s is the start of Advanced Trauma Life Support (ATLS) course, and the golden hours of trauma care has been based on an organized approach that aims to manage life threatening injuries. This ABCDE and trauma team approach can be applied to all critically injured patients and the goal of resuscitation is to restore organ perfusion. Resuscitation of Polytrauma patients should depend mainly on ATLS guidelines and Prophylactic measures should be respected to avoid the event e.g. wearing seat belt, helmet and controlling the speed of vehicles etc. The Role of ER team include TMT (Triage for Polytrauma, Management means life saving interventions, ABCDE approach, Transfer for definitive care) Key words : • Poly Trauma • Resuscitation• ATLS Guidelines