Polytrauma Management
Polytrauma means several serious injuries at once, where treating one can worsen another. It needs a group of teams working to a single plan rather than in turn, and it frequently means operating in stages: stabilise first, reconstruct once the patient can tolerate it.
- Several surgical teams working together
- Damage control surgery where needed
- Intensive care on site
- Reconstruction staged deliberately
Stay
Days to weeks
Duration
Resuscitation begins immediately
Anaesthesia
General, often over several operations
About Polytrauma Management
In multiple injury the priorities compete. Fixing a fracture takes time a bleeding abdomen does not have. Damage control surgery addresses what is immediately life-threatening, stops bleeding and contamination, and stops there. The patient is then stabilised in intensive care, and definitive reconstruction happens over the following days once they can tolerate a longer operation.
- Injuries are prioritised against each other, not treated in turn
- Damage control surgery is deliberate, not an incomplete operation
- Intensive care between operations is part of the plan
- Reconstruction happens over days to weeks
Before you read on
Everything here is general information about polytrauma management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest polytrauma management.
- Multiple injuries from a road accident
- Falls from height with several fractures
- Crush injuries
- Injury involving both the abdomen and the limbs
- Chest injury with fractures elsewhere
- Any patient with injuries crossing several specialities
Procedure details
The usual sequence, from first consultation through to follow-up.
Resuscitation
Airway, breathing and circulation are secured first, with blood given where needed and bleeding controlled.
Rapid imaging
CT of the relevant areas maps every injury, because a plan cannot be made from the visible ones alone.
Damage control surgery
The first operation stops bleeding and contamination and stabilises fractures temporarily. It is deliberately limited.
Stabilise then reconstruct
Intensive care restores temperature, clotting and circulation. Definitive surgery follows over the days after.
How to prepare
What to sort out before you come in.
- Nothing to prepare, this is an emergency
- Call 108 and do not move a seriously injured person unless they are in danger
- Family should bring medication and medical history when they can
- Expect several conversations over days, as the plan changes with the patient's condition
Recovery
What to expect afterwards, and roughly when.
- Recovery is measured in weeks to months rather than days
- Several operations are usual and are part of the plan rather than a sign of failure
- Physiotherapy begins in intensive care, not after discharge
- Nutrition is part of the treatment, because healing multiple injuries needs it
- Follow-up involves several specialities and is coordinated before discharge
Why choose Humayun for multiple injury
Polytrauma needs several teams working to one plan, which depends on them all being in the same building.
- Orthopaedic, general and anaesthetic teams called together rather than one after another
- Damage control surgery used deliberately, with reconstruction staged for when the patient can take it
- Intensive care on site, so nobody is transferred while unstable
- Rehabilitation planned from the first week rather than after discharge
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