Polytrauma
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Overview
Polytrauma is a medical term describing the condition of a person who has been subjected to multiple traumatic injuries, such as a serious head injury AND a serious burn.
The term has become common among US military doctors in describing the seriously injured soldiers returning from Operation Iraqi Freedom (Iraq) and Operation Enduring Freedom (Afghanistan). The term however is generic, and has been in use for a long time for any case involving multiple traumata.
Civilian medicine
In civilian life, polytraumas are often associated with motor vehicle accidents. This is because car accidents usually occur at a high velocity and subsequent injury is usually severe and consists of multiple damages. On admission to hospital any trauma patient should immediately undergo x-ray diagnosis of their cervical spine, chest and their pelvis, commonly known as a 'trauma series', to ascertain possible life threatening injuries. Examples would be a fractured cervical vertebra, a severely fractured pelvis, or a haemothorax. Once the initial survey is complete, x-rays can be taken of the limbs to assess for other possible fractures.
It is also quite common in severe trauma for patients to go straight to CT or a surgery theatre if they require emergency treatment.
A retrospective study of 93 children (average age of 8.0 +/- 4.1 years) with polytrauma and at least one major musculoskeletal injury showed that 80% of the incidents had been caused in this way (motor vehicle accident).[1]
Military medicine
Overview
Polytrauma often results from blast injuries sustained by improvised explosive devices, or by a hit with a rocket-propelled grenade, with "Improvised explosive devices, blasts, landmines, and fragments account[ing] for 65 percent of combat injuries...".[2] The combination of high-pressure waves, explosive fragments, and falling debris may produce multiple injuries including brain injury, loss of limbs, burns, fractures, blindness and hearing loss,[3] with 60 percent of those injured in this way having some degree of traumatic brain injury.[2]
In some ways, the existence of polytrauma is in fact a sign of medical advancement, for in previous wars, soldiers with such multiple damage types simply did not survive in most cases, even if quickly transferred into hospital care. The downside is however that many of the victims, though surviving, will never fully regain their physical or mental form. They are also prone to post traumatic stress disorder.[2]
U.S. treatment
There are currently (2007) four clinics in the US specialising in polytrauma. They are managed by the United States Department of Veterans Affairs and are located in Minneapolis, Minn., Palo Alto, Calif., Richmond, Va. and Tampa, Florida.[3] In addition to the actual intensive care insofar as still required, these hospitals mainly specialise in rehabilitative treatment.
The treatment and rehabilitative care for polytrauma patients is a very extensive and time-consuming activity. The recommended staffing numbers (FTE = Full Time Equivalent) for six rehabilitation treatment beds are:[2]
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In other words - 2.8 people are required full time for every patient, often for months, while some care may be required for decades.
References
- ↑ Factors predictive of immobilization Complications in pediatric polytrauma - Loder, Randall T. et al, Journal of Orthopaedic Trauma 2001, vol. 15, no5, pp. 338-341
- ↑ 2.0 2.1 2.2 2.3 Polytrauma Rehabilitation Procedures - Veterans Health Administration (VHA) Handbook, Thursday September 22 2005
- ↑ 3.0 3.1 President's Project: Support for VAMC Polytrauma Centers (from the American Legion Auxiliary website)
WikiDoc Research Resources for Polytrauma | |
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| Articles on Polytrauma | Most recent articles on Polytrauma • Most cited articles on Polytrauma • Review articles on Polytrauma • Articles on Polytrauma in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Polytrauma | Powerpoint slides on Polytrauma • Images of Polytrauma • Photos of Polytrauma • Podcasts & MP3s on Polytrauma • Videos on Polytrauma |
| Evidence Based Medicine Regarding Polytrauma | Cochrane Collaboration on Polytrauma • Bandolier on Polytrauma • TRIP on Polytrauma |
| Cost Effectiveness of Polytrauma | Cost Effectiveness of Polytrauma |
| Clinical Trials Involving Polytrauma | Ongoing Trials on Polytrauma at Clinical Trials.gov • Trial results on Polytrauma • Clinical Trials on Polytrauma at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Polytrauma | US National Guidelines Clearinghouse on Polytrauma • NICE Guidance on Polytrauma • NHS PRODIGY Guidance • FDA on Polytrauma • CDC on Polytrauma |
| Textbook Information on Polytrauma | Books and Textbook Information on Polytrauma |
| Pharmacology Resources on Polytrauma | Dosing of Polytrauma • Drug interactions with Polytrauma • Side effects of Polytrauma • Allergic reactions to Polytrauma • Overdose information on Polytrauma • Carcinogenicity information on Polytrauma • Polytrauma in pregnancy • Pharmacokinetics of Polytrauma • |
| Genetics, Pharmacogenomics, and Proteinomics of Polytrauma | Genetics of Polytrauma • Pharmacogenomics of Polytrauma • Proteomics of Polytrauma |
| Newstories on Polytrauma | Polytrauma in the news • Be alerted to news on Polytrauma • News trends on Polytrauma |
| Commentary on Polytrauma | Blogs on Polytrauma |
| Patient Resources on Polytrauma | Patient resources on Polytrauma • Discussion groups on Polytrauma • Patient Handouts on Polytrauma • Directions to Hospitals Treating Polytrauma • Risk calculators and risk factors for Polytrauma |
| Healthcare Provider Resources on Polytrauma | Symptoms of Polytrauma • Causes & Risk Factors for Polytrauma • Diagnostic studies for Polytrauma • Treatment of Polytrauma |
| Continuing Medical Education (CME) Programs on Polytrauma | CME Programs on Polytrauma |
| International Resources on Polytrauma | Polytrauma en Espanol • Polytrauma en Francais |
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| Informatics Resources on Polytrauma | List of terms related to Polytrauma |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
