Severe acute polytrauma represent states arising from accidents of mechanical , thermal or electrical and characterized by multiple lesions affecting organ systems or different regions ( at least two) of the body.
Polytrauma represents approximately 50% of all injuries . After WHO statistics , polytrauma is the third cause of death ( after cardiovascular disease and cancer ) . In peacetime , the commonest causes of polytrauma are accidents ( 90%), work accidents , sports accidents and catastrophes .
Politraumatizaţii can be divided into :
1 ) polytrauma that vital functions are altered with imminence of cardiopulmonary arrest ;
2 ) polytrauma that do not require extreme emergency measures , allow 1-2 hours for investigation ;
3 ) polytrauma allowing sufficient time for the diagnosis .
There are two stages of treatment for politraumatizaţilor :
I. treatment at the scene and during transport to the hospital unit will consist of :
– Evaluation and stabilization of vital functions ( circulatory , respiratory ) ;
– airway control , any property of voucher cost and evacuation of a pneumothorax ;
– Cardiac resuscitation in cardiac arrest ;
– Peripheral or central venous access ;
– Temporary hemostatic tourniquet or cord ;
– Transport to hospital as quickly .
II . Receiving hospital patient and lesion diagnosis :
– Rebalancing fluid and electrolyte ;
– Complete hemostasis ;
– Complete clinical examination and laboratory ;
– Installation of a venous safe ;
– Biological testing ( Ht , Hb, WBC , urea, creatinine, amylase , glucose , ionogramă , blood type and Rh ) ;
– Multiple radiographs according to the injury ;
– Ultrasound or CT;
– Peritoneal puncture performed to evaluate abdominal injuries ;
– ATPase vaccine .
Treatment is performed according to the patient’s general condition , as follows:
a) in extreme emergency surgery to remove the patient from hemorrhagic shock or respiratory condition , followed a few days to other interventions ;
b ) the general condition does not allow full assessment and laboratory investigations , perform surgery with completeness that solves Diagnosis of the cause and resulting injuries .