Polytrauma means multiple injuries. By definition, these are serious, life-threatening injuries. There is a risk of cardiovascular failure due to shock or traumatic brain injury in the case of polytrauma.
What is poly trauma?
Polytrauma (plural: polytraumas) is a term used in emergency medicine. The translation of the Greek word composition is “multiple violation”. This always means a severe injury, consisting of at least 2 injuries to a patient, either:
- on at least 2 body regions or
- various types of injuries to one or more parts of the body.
By definition, polytrauma is a condition with an acute danger to life. The threat to life can come from just one or more injuries at the same time. A volume deficiency shock caused by external or internal bleeding is also characteristic. See howsmb for Corneal Opacity Definition and Meaning.
There are scaled calculation systems for assessing and classifying the severity of an existing polytrauma. For example, the Injury Severity Score (GCS) is one of the most common scale systems for classifying polytrauma.
Causes
Polytrauma is the result of an act of violence. In the most common case, serious injuries occur in the context of traffic accidents, but work accidents also often cause polytrauma. Furthermore, it is violent crimes or suicide attempts such as falling from a window that are responsible for multiple injuries.
In the context of accidents, acute illnesses also play a role, which are possible triggers but are often misjudged. A traffic accident can be caused by a stroke, which initially remains undetected because the symptoms of the polytrauma overlay the apoplexy syndrome.
To make matters worse, intoxication with alcohol or drugs often also causes accidents. About 1% of all emergency patients with injuries suffer from polytrauma.
Symptoms, Ailments & Signs
Polytrauma can have many different symptoms. All of these symptoms are to be equated with the injuries, of which at least two must exist in order to define polytrauma. Furthermore, polytrauma usually also means that the person concerned is in a state of shock. Most often, unconsciousness occurs.
Typical symptoms of polytrauma are circulatory shock, severe craniocerebral trauma or spinal injuries. These ailments are among the most serious in such a trauma. Furthermore, broken ribs, injuries to the extremities, internal bleeding, the failure of individual organs or the appearance of large wounds can also occur. Furthermore, the injuries are further classified. Gunshot wounds or very severe bruises are also possible symptoms of polytrauma. In most cases, there is severe blood loss.
The trauma is the more severe, the more injuries have occurred. Similarly, the survival rate decreases with the severity and complexity of the injuries. In the first few days after the trauma occurs, there is also an increased risk of developing kidney failure or a fat embolism. Polytrauma usually means complete inability to act for those affected. Some sufferers also fall into a coma as a result of such trauma.
Diagnosis & History
A polytrauma can often be recognized by the rescue service based on the situation in which it was found and also on the condition of the patient. Diagnostically, the control of the vital signs is now in the foreground. Blood pressure, ECG and respiratory activity are decisive for the ability of the injured person to be transported.
The emergency doctor also has to choose the means of transport and, in serious cases, request a helicopter. The individual injuries can only be precisely determined in the clinic. An ultrasound examination provides the first findings on injuries to the internal organs, including the chest.
In addition, a full -body computed tomography is performed today. The classic X-ray image can also contribute to the diagnosis, but often cannot be created depending on the condition of the patient with polytrauma.
Complications
Polytrauma is defined as a condition in which the patient has sustained multiple serious injuries at the same time, at least one of which is life-threatening. The specific complications that can arise depend on the type of injury and the course of the accident.
Patients who have fractured both arms and legs at the same time are largely immobile for months and require 100 percent care. If the affected person is conscious, he suffers from enormous physical pain, which cannot always be completely suppressed even with medication. For many of those affected, the complete helplessness that occurs, especially when both arms are broken, is accompanied by great psychological stress.
The nursing measures, especially in the case of intimate activities, are often perceived as humiliating. If there is also an injury to the spine in connection with paralysis of the extremities, the patients usually feel no or significantly less pain because the nerve connection to the brain is interrupted.
The possibility of a permanent paralysis up to the complete loss of mobility of the limbs places an enormous psychological burden on those affected. Even if the injuries are not quite as serious, those affected face months of convalescence, with permanent damage being very likely.
When should you go to the doctor?
If irregularities or changes in the state of health appear due to an external influence on the body of the person concerned, a doctor should be consulted to clarify the symptoms. In acute situations, an ambulance is required to provide first aid. Those present are asked to provide emergency measures and first aid until the emergency doctor arrives. A loss of consciousness, impairment of orientation or an abnormality in memory function must be examined and treated. Headaches, severe blood loss and body pain must be examined by a doctor. If the body becomes deformed, the musculoskeletal system is restricted or open wounds are visible, the person concerned needs help.
In the case of blunt injuries, a violent blow to the head, as well as severe nausea with vomiting, a doctor’s visit is required. Polytrauma usually occurs after a serious fall, an accident or after the effects of violence. A doctor should be consulted to have injuries documented and treated. Contusions, limb injuries, and a hunched posture indicate irregularities that should be seen by a doctor. If internal bleeding occurs, breathing is blocked or the patient is in shock, immediate help is needed. Sudden discoloration of the skin, internal weakness and misaligned bones are signs of a disease and require medical attention.
Treatment & Therapy
In the case of polytrauma, the first aider is of great importance. He usually not only alerts the rescue service, but should also carry out acute life-saving measures. These immediate interventions are:
- the stable side position in case of unconsciousness,
- mouth- to -mouth cardiopulmonary resuscitation in cardiac arrest
or mouth-to-nose resuscitation and chest compressions as well
- hemostasis of external injuries by temporary wound closure
The rescue team continues the resuscitation using technical methods. The aim is to stabilize the patient, who needs to be put in a transportable condition. Infusions are administered to combat the volume depletion shock, which are supplemented by blood transfusions in the clinic.
The first thing the trauma surgeon will do is to stop the bleeding surgically. In the course of treatment, priority always has the injury that is acutely life-threatening, so the focus is specifically on the condition of the internal organs. The treatment of a craniocerebral trauma as well as fractures of the spine and large bones is also urgent. Because fractures of the pelvis or thigh can lead to life-threatening blood loss.
Minor injuries to the skeletal system are initially treated only provisionally. In general, the principle “treat first what kills first” applies. Treatment in the shock room and operating theater is usually followed by intensive medical monitoring with airway management. Because the patients are often in a coma, caused by polytrauma.
Prevention
Polytrauma and prevention is an issue of accident prevention. Safety regulations in the workplace, professional protective clothing and the attention to self-protection should never be forgotten. Since most polytraumas are caused by traffic accidents, this is also where the greatest prophylactic potential lies. Many road accidents result from not following the simplest rules from driving school. Anyone who observes them makes a contribution to avoiding polytrauma.
Aftercare
The aftercare measures for polytrauma can be very different. Depending on what injuries were present, either no follow-up care may be required at all, or extensive measures may need to be taken. In the treatment of broken bones, the affected joints are immobilized, causing the muscles that are not used to break down significantly.
Physiotherapy ensures that the joints are mobilized again and a targeted muscle build-up takes place. If certain functions of the body could not be restored despite the treatment, the aftercare aims to ensure that the patient has the highest possible quality of life despite his limitations. If, for example, disabilities have arisen as a result of amputations, training in how to use a prosthesis is part of the aftercare.
If the affected organs can no longer function at all or only to the full extent, close follow-up care is required. Training the patient helps them to better deal with the limitations. In this way, those affected can cope better with the new situation after polytrauma and remain as independent as possible. Polytrauma often has psychological consequences. These are not always recognized immediately and should also be taken into account with good aftercare.
You can do that yourself
Anyone who has survived a polytrauma will possibly remain “traumatized” for a long time afterwards. It often takes years for the sometimes life-threatening injuries to heal. From a medical point of view, perhaps everything that is necessary for the patient has been done – but what about his psyche ?
Clinics that belong to the trauma network offer special consultation hours for polytraumatized patients. Those affected will find contact persons and psychologists here who can provide assistance in overcoming this life crisis beyond medical matters. It is also advisable to join a self-help group. They are in all major cities. If you live in a rural area and are unable to regularly visit a distant group, you should definitely seek psychological support.
In addition, it is important to maintain friendships and not withdraw. The feeling of having been badly injured and helpless can be frightening beyond the actual injuries. Here it is important to actively counteract the fear and to do as many things as possible that are good for the soul. This can be a wellness holiday as well as a long, extensive bath.
