The Challenges of Polytrauma Care
Polytrauma or multiple trauma is a medical term for a condition where a person has suffered multiple traumatic injuries, such as a serious head injury and a grave burn, usually involving various body parts and organs. Traffic accidents, bomb blasts or wars are the most common triggers of polytrauma. Since multiple body parts are injured, treating a polytraumatized patient is far more medically challenging and demanding.
One of the biggest challenges of polytrauma care is time. Since India is still struggling to deal with emergencies effectively, it becomes difficult for patients to be admitted at the right time at the right place. It is extremely necessary that a polytrauma patient is hospitalized and treated immediately as the prognosis becomes poorer and the outcome is affected if the injuries sustained are left unattended for a long time.
In September 2015, CARE Hospitals registered a polytrauma case when a 17 month old baby was admitted after being run over by a school bus. She suffered massive life-threatening injuries and there was little hope of her survival. A team of multi-specialty experts, including a general surgeon, an orthopedic surgeon, a urologist, anesthetists and ER physicians operated on her. A plastic surgeon also worked on her post the main operation and the little girl not only survived but could lead a normal life a few months later. (Read the story of the miracle child here)
Since polytrauma demands the presence of multiple specialists, considerably more resources are needed and the decision making has to be very quick and urgent. The group of specialists who operate need to have great coordination skills and must communicate very clearly. As in any other trauma case, polytrauma requires that the surgeons strictly adhere to ATLS (advanced trauma life support) guidelines. Basically, ATLS is a training program developed by the American College of Surgeons and has been adopted worldwide in over 60 countries. It demands that various stages of surveys be done before the actual surgery and lays down ground rules to be followed during the surgical procedure.
The orthopedic surgeon has a very crucial role to play in polytrauma as most of the injuries are usually related to the spine or the bones. It is extremely necessary that every polytrauma team has an exceptional orthopedic surgeon with commendable experience and expertise.
While continuous efforts are being made to improve polytrauma care, the challenges still exist. The biggest challenge continues to be the restoration of the anatomy which is beyond the scope of surgical care at times. Also, when multiple disciplines come together to work on a single patient, it is quite a task to keep the operational costs within limits. In many cases, the polytraumatized patients end up needing rehabilitation which further adds to the complications.
The US Department of Veterans Affairs offers an intensive polytrauma system of care across the country. This system was introduced after the 9/11 attacks in 2001 and has been enhanced over the years to tackle the growing challenges. The services offered by this system include interdisciplinary evaluation and treatment, development of a comprehensive plan of care, case management, patient and family education and training, psychosocial support, and application of advanced rehabilitation treatments and prosthetic technologies. (Source)
In India, polytrauma care poses medical, technical and economic challenges. While we are still far from revolutionary solutions, we must begin the journey towards it. As part of the healthcare and medical industry, at CARE, we strive to tackle the challenges of polytrauma with strength, bravery and expertise that can give way to new medical breakthroughs.