The Polytraumatized Patient

Abstract

Polytraumatized patients require a multidisciplinary approach to obtain optimal outcomes. Mortality following trauma follows a trimodal temporal distribution. Appropriate fracture management in the second and third waves can reduce mortality rates. Fractures may be associated with substantial hemorrhage; providers must remember that fracture fixation supports hemodynamic resuscitation efforts. Injury Severity Score and hemorrhagic shock class represent important metrics for the classification and stabilization of trauma patients. Unlike hemorrhagic shock, neurogenic shock requires vasopressor support as the mainstay of treatment. Primary, secondary, and tertiary exams are mandatory in the polytraumatized patient. Suspected injuries entail appropriate advanced or plain radiographic imaging in order to ensure diagnostic accuracy. In general, fractures should undergo prompt closed reduction and immobilization, with either splints or bracing. Open fractures require antibiotics and tetanus updates. Prompt operative management of orthopedic injuries, assuming attainment of appropriate resuscitative parameters, improves long-term outcomes following polytrauma.