Polytrauma: Immediate Care and Injury Types

Posted on Feb 23, 2025 in Medicine & Health

Polytrauma: Understanding Multiple Traumatic Injuries

Polytrauma refers to multiple injuries affecting several body systems or organs. It is a leading cause of death among individuals aged 20-40. Common causes include:

  • Burns
  • Falls from height
  • Electrocution
  • Knife wounds
  • Motor vehicle accidents

Causes of Death in Polytrauma

Common causes of death related to polytrauma include:

  • Traumatic Brain Injury (TBI)
  • Airway obstruction due to blood or foreign objects
  • Heart failure
  • Acute anemia

Immediate Care at the Accident Scene

When attending to an accident victim, prioritize the following:

  1. Airway: Remove any visible obstacles hindering respiration.
  2. Breathing: Check for normal coloring in fingers, ears, and lips (pink indicates adequate breathing). If cyanosis (bluish discoloration) is present, carefully examine the airway and initiate mouth-to-mouth resuscitation, regardless of consciousness.
  3. Consciousness: Assess the victim’s level of consciousness by asking three simple questions.
  4. Spinal Immobilization: If the victim is unconscious, immobilize the spine to prevent movement and potential quadriplegia.
  5. General Immobilization: Immobilize the spine in general.
  6. Bleeding: Check for any bleeding and apply direct pressure with a clean cloth.
  7. Transport: Determine the appropriate method of moving the injured person based on their condition.

What NOT to Do

  • Never panic.
  • Avoid moving the victim abruptly.
  • Do not give liquids to an unconscious person.
  • Do not cover the victim with blankets if they are having difficulty breathing.

Traumatic Brain Injury (TBI)

TBI results from a blow to the head, causing the brain to impact the skull walls. A skull fracture is not always present. TBI can lead to:

  • Inflammation
  • Bleeding (intracranial hemorrhage)
  • Unconsciousness
  • Death

Diagnosis of TBI

  • Radiology (X-ray): To detect skull fractures.
  • CT Scan (Computed Tomography): The preferred method for visualizing TBI and soft tissue injuries.
  • MRI (Magnetic Resonance Imaging): Provides a comprehensive assessment and helps evaluate effects not explained by CT scans.

Severe Head Injuries

More severe head injuries can cause:

  • Concussions and unconsciousness
  • Seizures
  • Skull or facial fractures
  • Discharge from the face, mouth, or ears
  • Speech difficulties or blurred vision

Unconsciousness

Unconsciousness is a loss of awareness and inability to respond to stimuli. A prolonged state of unconsciousness is called a coma.

Checking Mental Status

Assess a person’s alertness by asking simple questions. If the individual is disoriented or unresponsive, their mental status is considered decreased. Alcohol consumption is a common cause of altered mental status.

Loss of Consciousness: Fainting

Fainting can result from dehydration or low blood sugar. If someone faints, position them on their back and elevate their feet.

Fainting is a temporary or prolonged loss of consciousness. Always check the airway and circulation.

What NOT to Do with an Unconscious Victim

  • Do not leave the victim alone.
  • Do not give food or drink.
  • Do not place a pillow under their head.
  • Do not slap or throw water on them.

Kinetics of Trauma

Trauma is an injury caused by external force or violence. Collisions result from the impact of two or more moving bodies.

Penetrating Trauma

Penetrating trauma is caused by projectiles, resulting in:

  • Penetration and fragmentation
  • Permanent cavitation: Tissue destruction.
  • Temporary cavitation: Compression waves and stretching.

The extent of damage in penetrating injuries depends on the structures pierced and the permanent cavitation caused by the object.

Mechanical Injuries

Mechanical injuries are caused by momentum transfer, either from the patient or the object impacting the patient. The severity of the injury depends on:

  • The amount of energy applied.
  • The rate of energy application.
  • The body part affected.

Heimlich Maneuver

The Heimlich maneuver is used when a person experiences sudden suffocation due to choking. This can be caused by food or a foreign object becoming lodged at the junction of the esophagus and trachea, pushing the epiglottis and obstructing breathing.