Treatment of polytrauma
- Therapy of circulatory disorders. It is necessary to constantly monitor the condition of the victim. ...
- Correction of respiratory disorders. ...
- Transfusion therapy. ...
- Anesthesia. ...
- Food. ...
- Infectious complications. ...
- Peripheral injuries and complications. ...
- Prevention of major complications. ...
- Prevention of nosocomial infection. ...
What is polytrauma in medical terms?
Polytrauma describes multiple complex injuries of the brain and body typically caused by explosive blasts from car bombs, shells and flying shrapnel. The condition is commonly characterized by multiple head injuries, vision and hearing loss, nerve damage, multiple bone fractures, unhealed body wounds and infections - either of which can be life threatening.
What is polytrauma/TBI system of care?
Jun 03, 2015 · Treatment at outpatient TBI and polytrauma clinics emphasizes improvement of symptoms (such as managing headaches, pain, sleep) and training in using strategies and assistive technology devices to manage difficulties in performing activities of daily living. In addition to rehabilitation services, veterans and service members recovering from ...
What is the hallmark of care for polytrauma?
Polytrauma typically refers to severely injured patients with two or more significant traumatic injuries, with a total injury severity score of greater than 15, or an abbreviated injury scale > 2 in at least two injury severity score regions ( Butcher and Balogh, 2009; Pape, 2012; Butcher et al., 2014 ). (For an explanation of severity scoring, see …
What is the significance of inflammation in polytrauma patients with orthopaedic injuries?
Feb 23, 2021 · The management of polytrauma patients with orthopaedic injuries is a complex and dynamic process that requires a robust understanding of the pathophysiology of the response to trauma and indicators of patient status. ... yet development of safe and expeditious treatment plans, including type and timing of fixation, remains controversial. We ...
What is a polytrauma patient?
Abstract. Polytrauma (multitrauma) is a short verbal equivalent used for severely injured patients usually with associated injury (i.e. two or more severe injuries in at least two areas of the body), less often with a multiple injury (i.e. two or more severe injuries in one body area).
What causes polytrauma?
Polytrauma is when a patient has sustained multiple injuries, some of which may cause significant disability and may be life-threatening. Worldwide the most common cause of polytrauma is motor vehicle accidents; other causes include suicide and homicide attempts.Jul 5, 2021
What is polytrauma rehab?
Polytrauma Rehabilitation Centers (PRCs) provide acute, comprehensive, inpatient rehabilitation. They maintain a full team of dedicated rehabilitation professionals and consultants from other specialties related to polytrauma. The Centers serve as consultants to other facilities in the Polytrauma System of Care.
What is polytrauma at the VA?
VA's Polytrauma System of Care (PSC) is an integrated network of specialized rehabilitation programs dedicated to serving Veterans and Service Members with both combat and civilian related Traumatic Brain Injury (TBI) and polytrauma.
How do you manage a patient with polytrauma?
In the polytrauma patient, all fractures should be initially immobilized, and the dislocations reduced and provisionally immobilized. Indications for surgery are recovery of spinal alignment, unstable lesions, neurological damage, and open fractures.Mar 10, 2014
What is hemorrhagic shock in polytrauma?
Hemorrhagic shock was defined as low blood pressure (systolic blood pressure < 90 mm Hg), low urine output (<30 mL/h), and a blood lactate level greater than 2 mmol/L (23).Jul 1, 2011
What is to be addressed first in a case of polytrauma?
The procedure being followed in the ED to treat patients with poly trauma. Step 1: Initial assessment and preparation of treatment plan. As the patient enters the emergency he is attended by a general surgeon. Step 2: Patient's information sent to other referral specialties.
What is tertiary trauma?
The Tertiary Trauma Survey (TTS) is a patient evaluation that identifies and catalogues all injuries after the initial resuscitation and any subsequent emergent operative interventions. It is a comprehensive review of the medical record with emphasis on the mechanism of injury and pertinent co-morbid factors.Apr 1, 2017
What is a blunt trauma?
Definitions. Blunt force trauma: Injuries resulting from an impact with a dull, firm surface or object. Individual injuries may be patterned (eg ,characteristics of the wound suggest a particular type of blunt object) or nonspecific.Mar 2, 2016
What is diffuse anoxic brain injury?
Diffuse axonal injury (DAI) is a form of traumatic brain injury. It happens when the brain rapidly shifts inside the skull as an injury is occurring. The long connecting fibers in the brain called axons are sheared as the brain rapidly accelerates and decelerates inside the hard bone of the skull.
How does the VA rate TBI?
The VA rates TBI at 0, 10, 40, 70, and 100 percent. They recognize that there are certain cases so severe that warrant a rating higher than 100%, such as when the veteran cannot work due to the injury. The VA recognized the old schedule for rating brain disease due to trauma needed to be updated.Mar 25, 2022
What is an injury that is defined as injury to the brain?
Traumatic brain injury (TBI) is a sudden injury that causes damage to the brain. It may happen when there is a blow, bump, or jolt to the head. This is a closed head injury. A TBI can also happen when an object penetrates the skull.Feb 7, 2022
Acute Inpatient Rehabilitation
Most people who sustained moderate to severe TBI and polytrauma are admitted to a rehabilitation unit or hospital. Veterans and service members with moderate to severe injuries are typically referred for admission to one of the five VA's Polytrauma Rehabilitation Centers (PRC).
Transitional Rehabilitation
VA's Polytrauma Transitional Rehabilitation Program (PTRP) is an interdisciplinary residential rehabilitation program with focus on independent living and community reintegration. There are currently five PTRPs nationally, located at the VAMCs in Minneapolis, Palo Alto, Richmond, San Antonio, and Tampa.
Outpatient Rehabilitation
Veterans with mild TBI and polytrauma and those with moderate to severe injuries who completed a course of inpatient rehabilitation often receive rehabilitation care in outpatient clinics. VA developed specialized outpatient clinics and teams at 23 Polytrauma Network Sites and 87 Polytrauma Support Clinic Team facilities.
What is the risk of polytrauma?
In polytrauma patients the risk of infection can be increased significantly secondary to intubation, invasive lines, and placement of intracranial monitors. Infections can be broken down into infection/colonization of ICP monitors and infection/colonization of peripheral lines/pneumonia. Most trials of prophylactic antibiotics have shown selection of more virulent gram-negative organisms. Currently BTF guidelines recommend at a level II the use of periprocedural antibiotics for intubation to reduce the incidence of pneumonia.9 This does not change length of stay or mortality rates. Early tracheostomy reduces mechanical ventilation days, but it does not alter mortality rate or nosocomial pneumonia rate. There is level III evidence against the routine use of prophylactic antibiotics for ventricular catheter placement. 9 There is currently level III evidence against the routine use of ventricular catheter exchange to prevent infection. 9
What is polytrauma score?
Polytrauma typically refers to severely injured patients with two or more significant traumatic injuries, with a total injury severity score of greater than 15, or an abbreviated injury scale > 2 in at least two injury severity score regions ( Butcher and Balogh, 2009; Pape, 2012; Butcher et al., 2014 ). (For an explanation of severity scoring, see ...
What is the goal of acute care for multiple injuries?
The goal of the acute care of the multiply injured child is to allow the child to transition to the rehabilitation phase of care as rapidly as possible. Pediatric rehabilitation services have been shown to be beneficial to a broad spectrum of pediatric trauma patients (both with and without significant head injuries), and significant gains have been documented in mobility, self-care, and cognition. More rapid transitions from acute care to rehabilitation services have been correlated with better functional outcomes.21,106 The purpose of this chapter is to outline important aspects of both the inpatient and outpatient rehabilitation treatment of the child with multiple injuries.
Is a polytrauma a headache?
Polytrauma, including traumatic brain injury, has been associated with significant pain sequelae.1 Postconcussive headache (PCH) has historically been viewed as a singular headache disorder with some quoting an incidence of headache occurring in nearly 90% of concussive brain injuries (CBIs) with a fairly alarming rate of chronicity.
What is polytrauma hospitalization?
All victims with suspicion of polytrauma for examination and treatment are hospitalized in a hospital with the possibility of providing specialized care. It is necessary to adhere to the logical strategy of hospitalization, which allows ultimately to get the most rapid recovery of the victim with the least number of complications, and not trivial to deliver the patient to the nearest medical institution. In the majority of victims with a combined trauma, the condition is initially assessed as severe or extremely difficult, so they are hospitalized in the ICU. When surgical intervention is required, intensive therapy is used as preoperative preparation, its purpose is to maintain vital functions and minimal sufficient preparation of the patient for surgery. Depending on the nature of the damage, patients need to be hospitalized or transferred to specialized hospitals - spinal cord injuries, burns, microsurgery, poisonings, psychiatric.
What is the goal of trauma treatment?
The goals of the treatment are intensive therapy of victims with a combined trauma - a system of medical measures aimed at preventing and correcting violations of life-critical functions, ensuring normal responses of the body to damage and achieving sustainable compensation.
What is the most common cause of combined trauma?
The most common cause of combined trauma is auto- and railway accidents, falling from height, violent damage (including gunshot and mine-explosive injuries, etc.). According to German researchers, in 55% of cases, polytrauma is the result of an accident, in 24% - industrial injuries and active rest, in 14% - falls from height. The most complex combinations of injuries are noted after an accident (57%), with chest injuries occurring in 45% of cases, TBC in 39%, and injuries in 69%. Important for the prediction of CCT, chest and abdominal trauma (in particular with a bleeding in the pre-hospital stage). Damage to the organs of the stomach and pelvic bones as a component of polytrauma is met in 25-35% of all cases (and in 97% they are closed). Due to the high incidence of soft tissue damage and bleeding, the lethality in pelvic injuries is 55% of cases. Damage to the spine as a component of polytrauma is met in 15-30% of all cases, in connection with which every patient is unconsciously suspected of spinal trauma.
How many classifications are there for traumatic injuries?
Among the more than 50 classifications proposed for quantifying the severity of traumatic injuries and the prognosis of the disease, only a few have become widespread. The main requirements for scoring systems are high predictive value and convenience in application:
What happens when you have injuries to your limbs?
When injuries of limbs often damage the nerves and muscles, thrombosis of blood vessels, violation of blood supply, which ultimately can lead to the development of compression syndrome and rhabdomyolysis. With regard to the development of these complications, increased alertness is needed to perform corrective surgery as soon as possible.
Can adrenaline be administered endotracheally?
If the intubation of the trachea is performed prior to catheterization of the central vein, then adrenaline, lidocaine and atropine can be administered endotracheally, increasing the dose by 2-2.5 times compared with that required for intravenous administration.
What is a polytrauma?
Polytrauma is defined as two or more injuries sustained in the same incident, one of which may be life threatening, which affect multiple body parts and organ systems and result in physical, cognitive, emotional, and behavioral impairments and functional disabilities. TBI frequently occurs in polytrauma in combination with other disabling conditions, such as: traumatic amputations, open wounds, musculoskeletal injuries, burns, pain, auditory and visual impairments, post-traumatic stress disorder (PTSD), and other mental health problems. When present, injury to the brain often leads the course of rehabilitation due to the complexity of the related cognitive, emotional, and behavioral deficits.
What is the VHA directive?
REASON FOR ISSUE: This Veterans Health Administration (VHA) directive defines policy, staffing requirements, and procedures for the operation of the Polytrauma System of Care (PSC).
What is EC program?
The EC program is a highly-specialized protocol for the rehabilitation of the Veterans and Servicemembers who are slow to recover consciousness after severe injuries. The goal of the program is to deliver the right balance of medical and therapeutic interventions to improve responsiveness and return to consciousness, to minimize complications, and to facilitate progress towards the next level of rehabilitation care. The EC Program is part of the continuum of rehabilitation services offered at the 5 PRCs.
Does VHA cover TBI?
It is VHA policy that eligible Veterans and Servicemembers with TBI and poly trauma have access to all medical and rehabilitation services provided through the Polytrauma System of Care as clinically indicated.
What is multitrauma in medical terms?
In practical use, multitrauma usually describes a patient emerging from an incident where: They have two or more associated serious injuries in at least two areas of the body, or. They have two or more injuries of different types in one area of the body.
What is the AIS scale?
First introduced in 1969 and updated regularly since then, the Abbreviated Injury Scale (AIS) serves as a quick way to measure injury severity. Using a scale between 1 and 6, with 1 being a minor injury, 5 representing the most severe, and 6 signifying a fatal injury, each of 9 areas of the body. Typically, first responders make the initial AIS assessment, and it’s the point of identification of polytrauma.
