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Review
. 2023 Mar 21:15:27-38.
doi: 10.2147/ORR.S340532. eCollection 2023.

Risks in the Management of Polytrauma Patients: Clinical Insights

Karthikeyan P Iyengar  1 , Aakaash S Venkatesan  2 , Vijay K Jain  3 , Madapura K Shashidhara  4 , Husam Elbana  5 , Rajesh Botchu  6
Affiliations
Review

Risks in the Management of Polytrauma Patients: Clinical Insights

Karthikeyan P Iyengar et al. Orthop Res Rev. .

Abstract

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.

Keywords: abbreviated injury scale; early appropriate care; polytrauma; resuscitation; shock; trauma related coagulopathy.

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Conflict of interest statement

Dr Madapura K Shashidhara is ACS and RCS England approved ATLS Director and Instructor. The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The figure illustrates the “Tri-modal Peaks Distribution’ of deaths after polytrauma. The timeline of these events in on the Horizontal axis and contributed deaths on the “Y” Axis. The ‘Text boxes’ highlight the period following the trauma and suggested Interventions that can be undertaken to mitigate these Risks.
Figure 2
Figure 2
The figure depicts the pathophysiology and mechanisms leading to lethal triad of mortality and late deaths in polytrauma patients.
See this image and copyright information in PMC

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