Management of polytrauma-a prospective observational study
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 7005-7012
AbstractBackground : The definition of polytrauma varies among different specialty and different countries, polytrauma patients are the subgroup of severely injured patients who have sustained injuries to more than one body region and organ with any one of the injury being life threatening.
Aim and objective: The aim of the present study to assess the management of polytrauma with early appropriate care.
Materials and Methods: This prospective observational study was carried out in the department of Orthopaedics, Vardhman Institute of Medical Sciences, Pawapuri, Nalanda, India. from January 2017 to March 2018. Total 100 patients with polytrauma were included in the study all were managed by Early Appropriate Care.
Result: Of the 100 patients with poly trauma, 73 (73%) were male and 27 (27%) female. Most of the patients 44 (44%) with poly trauma were in the age group of 30 to 40 years, followed by 27(27%) above 40 years. Out of 100 patients managed using EAC protocol, 16 patients had major complications. 14 out of 16 cases developed fat embolism following surgical intervention as there was involvement of long bones and 2 patient developed deep vein thrombosis (DVT) and ultimately leading to pulmonary embolism (PE). All these cases were treated and managed in the intensive care unit (ICU) for an average period of around 10 days. 2 patients with DVT and PE required mechanical ventilation whereas in the other 3 patients with fat embolism, oxygenation via mask, intravenous fluids and supportive care were sufficient.
Conclusion: the low incidence of mortality seems to be associated with EAC protocol. Following adequate resuscitation and correction of acidosis early definitive fixation is possible for bony injuries of polytrauma patients which avoids the need of second surgery.
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