Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
POLYTRAUMA_NEW[1] PPT NURSING MSC1.pptx
1. KING GEORGE’S MEDICAL UNIVERSITY
KGMU COLLEGE OF NURSING
MODELS OF HEALTH AND ILLNESS
Presented By:
Mr. Vishal Dubey
M.Sc. Nursing 1st Year (2023-2025)
King George’s Medical University
POLYTRAUMA
2. INJURY
The result of a harmful event that
arises from the release of specific
forms of energy.
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4. POLYTRAUMA
DEFINITION
Polytrauma is a generic term describing a patient who has suffered
multiple traumatic injuries at once. Also known as multiple
trauma, this can describe someone who has suffered a serious
head injury as well as a serious burn. For injuries to be
categorized as major trauma, an injury severity score (ISS) of at
least 16 is needed.
POLYTRAUMA
5. INTRODUCTION
Polytrauma refers to the condition in which a person sustains
multiple traumatic injuries to different body systems or organs
as a result of a single traumatic event. These injuries can be
life-threatening and often require immediate medical attention
and a coordinated approach to diagnosis and treatment.
Polytrauma can result from various incidents, such as car
accidents, falls from heights, industrial accidents, or acts of
violence.
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6. KEY CHARACTERISTICS OF POLYTRAUMA INCLUDE
1.Multiple Injuries: Polytrauma patients typically have injuries in
multiple anatomical regions, which can include the head, chest,
abdomen, pelvis, extremities, and spinal cord.
2.Severity: The injuries sustained in polytrauma cases are often
severe and can involve damage to vital organs or systems, making
them potentially life-threatening.
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7. 3.Complexity: Managing polytrauma patients is complex because
healthcare providers need to address a wide range of injuries
simultaneously, considering their interplay and potential
complications.
4.Multidisciplinary Approach: Effective care for polytrauma
patients requires a multidisciplinary team of healthcare
professionals, including trauma surgeons, orthopedic surgeons,
neurosurgeons, critical care specialists, nurses, and physical
therapists, among others.
KEY CHARACTERISTICS OF POLYTRAUMA INCLUDE
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8. 5.Immediate Stabilization: The initial focus in polytrauma
cases is on stabilizing the patient to ensure their immediate
survival. This may involve airway management, controlling
bleeding, and assessing for potential brain or spinal cord injuries.
6.Diagnostic Imaging: Imaging studies such as X-rays, CT
scans, and MRIs are often used to assess the extent of injuries
and aid in treatment planning.
KEY CHARACTERISTICS OF POLYTRAUMA INCLUDE
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9. 7.Surgical Intervention: Surgery may be necessary to repair or
stabilize injuries, including fractures, internal bleeding, or damage to
internal organs.
8.Rehabilitation: After the initial phase of treatment, rehabilitation
plays a critical role in helping polytrauma patients recover and
regain functionality. Physical therapy, occupational therapy, and
psychological support are often part of the rehabilitation process.
KEY CHARACTERISTICS OF POLYTRAUMA INCLUDE
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10. 9.Long-Term Care: Depending on the severity of injuries,
some polytrauma patients may require long-term care and
ongoing medical management
KEY CHARACTERISTICS OF POLYTRAUMA INCLUDE
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11. ETIOLOGY
• Car accidents are the main cause
of polytrauma.
• In a military setting polytrauma
is often a result of a blast-related
event.
• Traumatic brain injury (TBI) also
frequently occurs in military
polytrauma patients, as well as
amputation, burns and spinal cord injuries. POLYTRAUMA
12. SYMPTOMS OF POLYTRAUMA
• Trauma can affect the body in unpredictable ways, so it’s difficult
to pinpoint specific symptoms of polytrauma.
• Direct symptoms include severe pain or bleeding from different
areas of the body.
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13. DIAGNOSIS OF POLYTRAUMA
• Pain
• Discomfort
• X-rays to identify injuries in the spine, chest or pelvis, affecting
the limbs.
• CT scans or MRIs may also be needed to provide more detailed
information about certain injuries.
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14. TRIAGE
Triage based on
• Ability to walk
• Airway
• Respiratory rate
• Pulse rate or capillary return
15. How to triage?
1. Can the patient walk?
Yes -delayed
No -check for breathing
2. Is the patient breathing?
No -open the airway
Are they breathing now?
Yes -IMMEDIATE
No- Dead
TRIAGE
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19. TRIAGE SIEVE – To separate dead & the walking from the injured
TRIAGE SORT – To categorise the casualties according to local
protocols.
Category1 : Critical & cannot wait.
Category2 : Urgent – can wait for 30 mins at most
Category3 : Less serious injuries.
Category4 : Expectant – survival not likely.
TRIAGE
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20. Triage categories
Cat Definition Colour Treatment Example
P1
Life-
threatening
Red Immediate Tension pneumothorax
P2 Urgent Yellow Urgent Fractured femur
P3 Minor Green Delayed Sprained ankle
P4 Dead White
BLACK
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21. HOW TO MOVE UNCONSCIOUS CASUALTY
• Do not move the casualty unless it is absolutely necessary
• Assume neck injury until proved otherwise support head and
neck with your hands, so he can breathe freely apply a collar,
if possible
• There should be only 1 axis (head, neck, thorax) no moving to
sides, no flexion, no extension.
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22. • Move with the help of 3-4 people, 1 support head (he/she is
directing others), other one shoulders and chest, other one hips and
abdomen, last one legs.
• Applying cervical collar
• Log rolling and spinal board
• Inline Immobilization
• Spinal clearance
HOW TO MOVE UNCONSCIOUS CASUALTY
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24. Primary survey and resuscitation
• A = Airway and cervical spine
• B = Breathing
• C = Circulation and haemorrhage control
• D = Dysfunction of the central nervous system
• E = Exposure
ASSESSMENT OF THE INJURED PATIENT
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25. • Adjunct to primary survey: Xrays , USG
• Secondary survey
• Definitive treatment
• Consider Early Transfer
ASSESSMENT OF THE INJURED PATIENT
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26. • Tetanus
• Fat embolism
• Crush syndrome
• Multisystem organ failure (M.S.O.F.)
COMPLICATIONS OF POLYTRAUMA
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27. Fat embolism
• Around 72 hours
• Tachycardia
• Tachypnoea
• Dyspnoea
• Chest pain
• Petechial haemorrhage
Treated with mechanical ventilation,anticoagulants,anticoagulants
COMPLICATIONS OF POLYTRAUMA
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28. Disseminated intravascular coagulation
• Follows severe blood loss and sepsis
• Restlessness , confusion,neurological dysfunction,skin
infercation,oligurea
• Excessive bleeding
• Prolonged PT,PTT,TT
• Treatment– prevention and early correction and shock
COMPLICATIONS OF POLYTRAUMA
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29. Crush syndrome
• When a limb remains compressed for many hours
• Compartment syndrome and further ischaemia
• Cardiac arrest due to metabolic changes in blood
• Renal failure
Treatment
• Prevention-ensure high urine flow during extrication
• IV Crystalloids,Forced mannitol alkaline diuresis
• Fasciotomy and excision of devitalised muscles
• Amputation
COMPLICATIONS OF POLYTRAUMA
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30. Multisystem organ failure
• Progressive and sequential dysfunction of physiological systems
Characterised by two or more of the following
Temperature >38º C or < 36ºC
Tachycardia >90 /min
Respiratory rate >20/min
WBC count >12,000/cmm or <4,000/cmm
COMPLICATIONS OF POLYTRAUMA
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31. NURSING RESPONSIBILITIES
Polytrauma patient (someone with multiple severe injuries)
are extensive and crucial for providing comprehensive care
and promoting recovery.
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32. 1.Assessment and Triage:
Conduct a rapid and thorough initial assessment to identify life-
threatening injuries and prioritize care based on the ABCDE
approach (Airway, Breathing, Circulation, Disability,
Exposure).
2.Stabilization:
Assist with interventions to stabilize the patient, such as
securing the airway, administering oxygen, and controlling
bleeding.
NURSING RESPONSIBILITIES
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33. 3.Continuous Monitoring:
• Continuously monitor vital signs, neurological status, oxygen saturation,
and cardiac rhythm.
• Perform regular neurological assessments to detect any changes in
mental status.
4.Pain Management:
• Assess and manage the patient's pain using appropriate analgesics,
ensuring adequate pain relief while considering potential side effects.
NURSING RESPONSIBILITIES
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34. NURSING RESPONSIBILITIES
5.Immobilization:
• Ensure proper immobilization of fractures and
dislocations to prevent further injury.
• Follow established protocols for spinal precautions when
indicated.
6.Diagnostic Tests:
• Assist in ordering and interpreting diagnostic tests such
as X-rays, CT scans, and lab work to assess the extent
of injuries.
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35. NURSING RESPONSIBILITIES
7.Wound Care:
• Provide meticulous wound care, including cleaning, dressing
changes, and infection prevention.
• Monitor wounds for signs of infection or complications.
8.Medication Management:
• Administer prescribed medications, including antibiotics
for infection prevention and prophylaxis.
• Monitor for adverse reactions to medications.
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36. NURSING RESPONSIBILITIES
9. Fluid and Blood Product Administration:
• Administer intravenous fluids and blood products as needed to
maintain hemodynamic stability.
10.Nutritional Support:
• Assess nutritional status and provide enteral or parenteral
nutrition as necessary to support healing and recovery.
POLYTRAUMA
37. NURSING RESPONSIBILITIES
11.Respiratory Care:
• Monitor and manage respiratory status, including providing
respiratory treatments, suctioning, and ensuring adequate
oxygenation.
12.Psychosocial Support:
• Offer emotional support to the patient and their family,
addressing their concerns and providing information about the
patient's condition and prognosis.
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38. NURSING RESPONSIBILITIES
13.Coordination of Care:
• Collaborate with the healthcare team, including surgeons,
specialists, and therapists, to develop and implement a
comprehensive care plan.
• Ensure seamless transitions of care within the healthcare
facility or to other facilities if necessary.
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39. NURSING RESPONSIBILITIES
14.Documentation:
• Maintain accurate and thorough medical records,
documenting assessments, interventions, and patient
responses.
15.Patient Education:
• Provide education to the patient and family about the
injuries, treatment plan, and rehabilitation process.
• Ensure they understand discharge instructions and follow-up
care. POLYTRAUMA
40. NURSING RESPONSIBILITIES
16.Prevention of Complications:
• Implement measures to prevent complications such as
deep vein thrombosis (DVT), pressure ulcers, and
ventilator-associated pneumonia.
17.Advocacy:
• Serve as an advocate for the patient's needs and rights,
ensuring that their care aligns with their best interests.
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41. NURSING RESPONSIBILITIES
Polytrauma nursing care is complex and demands a
multidisciplinary approach. Nurses play a central role in
providing timely, compassionate, and evidence-based care
to promote the best possible outcomes for patients with
multiple severe injuries.
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42. SUMMARY
• Polytrauma refers to a condition in which an individual sustains multiple severe injuries, often
involving multiple body systems or organs. These injuries are typically the result of high-impact
accidents or traumatic events such as car crashes, falls from significant heights, or combat-related
incidents. Polytrauma patients often present with a combination of injuries that may include fractures,
head trauma, internal organ damage, and soft tissue injuries. Polytrauma patients face a complex array
of injuries that can challenge healthcare providers in terms of diagnosis, treatment, and management.
Polytrauma can have profound psychosocial effects on patients and their families. Coping with the
physical and emotional aftermath of severe trauma is a significant challenge.
• Preventing polytrauma often involves public health and safety measures, such as road safety
campaigns, fall prevention initiatives, and safety protocols in high-risk environments. In essence,
polytrauma represents a complex and challenging condition that demands a coordinated and
multidisciplinary approach to provide the best possible care, support, and rehabilitation for affected
individuals. The ultimate goal is to help polytrauma survivors achieve the highest possible quality of
life and functional independence.
43. BIBLIOGRAPHY
• Sasser, S. M., Hunt, R. C., Faul, M., Sugerman, D., Pearson, W. S., & Dulski, T. et al. (2012). Guidelines for field
triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. Morbidity and
Mortality Weekly Report: Recommendations and Reports, 61(1), 1-20.2.
• Osborn, J. A., & Berg, G. M. (2019). Management of Polytrauma. In StatPearls [Internet]. StatPearls
Publishing.3. Pfeifer, R., & Pape, H. C. (2010). Missed injuries in trauma patients: a literature review. Patient
Safety in Surgery, 4(1), 20.4. Gaarder, C., & Naess, P. A. (2012). Fracture patterns in major trauma. Journal of
Trauma and Acute Care Surgery, 72(3), 609-613.5.
• Gabbe, B. J., Cameron, P. A., & Wolfe, R. (2012). TRISS: does it get better than this? Academic Emergency
Medicine, 19(2), 135-137.6. Giannoudis, P. V., Harwood, P. J., Court-Brown, C., Pape, H. C., & Severe Trauma
Outcome Study (STOS) Group. (2013). Long bone non-unions treated with the diamond concept: a case series of
64 patients. Injury, 44(1), 101-106.7.
• Scalea, T. M., Simon, H. M., Duncan, A. O., Atweh, N. A., Sclafani, S. J., & Phillips, T. F. (1990). Geriatric blunt
multiple trauma: improved survival with early invasive monitoring. Journal of Trauma and Acute Care Surgery,
30(11), 129-136.
• Please note that this bibliography includes a range of sources related to polytrauma, including guidelines for field
triage, management, missed injuries, fracture patterns, and more.
