Polytrauma

Polytrauma is a medical condition in which a person sustains multiple injuries in more than one body region, with at least one life-threatening injury or physiologic derangement. It is commonly seen after high-energy events such as vehicle crashes, falls from height, or violent trauma. The term emphasizes the combined burden of injuries and their systemic consequences rather than a single traumatic lesion.

Assessment and triage: Early management follows trauma principles (airway, breathing, circulation, disability, exposure) with spinal protection as needed. The primary survey is followed by a secondary survey to identify all injuries. Rapid hemorrhage control, vascular access, and appropriate imaging guide resuscitation. Injury severity is quantified by scoring systems such as the Injury Severity Score and the Abbreviated Injury Scale; higher scores indicate greater risk. In practice, decisions are clinical and depend on physiological status, mechanism of injury, and available resources.

Management: Polytrauma care is typically delivered by multidisciplinary teams at designated trauma centers. Initial priorities include controlling bleeding, maintaining airway and perfusion, and preventing secondary brain injury. Damage control resuscitation aims to minimize hemodilution and coagulopathy. Treatments may involve temporary stabilization, staged surgical procedures, blood products, and organ support. Antifibrinolytics may be used when indicated, and complications such as shock, acute respiratory distress syndrome, infection, or organ failure require ongoing monitoring.

Prognosis and outcomes: Survival depends on injury burden, physiologic reserve, age, and comorbidity, as well as timeliness and quality of care. Rehabilitation and secondary prevention are important for long-term recovery.

Prevention: Safety measures, such as seat belts, helmets, fall prevention, and violence reduction, reduce the incidence and severity of polytrauma.