Polytrauma

Key takeaways

Polytrauma belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Polytrauma to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Polytrauma from memory before moving on to harder problems.

Reference excerpt

Polytrauma and multiple trauma are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries, such as a serious head injury in addition to a serious burn. The term is defined via an Injury Severity Score (ISS) equal to or greater than 16. It has become a commonly applied term by US military physicians in describing the seriously injured soldiers returning from Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in Afghanistan. The term is generic, however, and has been in use for a long time for any case involving multiple trauma.

Civilian medicine In civilian life, polytraumas often are associated with motor vehicle crashes. This is because car crashes often occur at high velocities, causing multiple injuries. On admission to hospital any trauma patient should immediately undergo x-ray diagnosis of their cervical spine, chest, and pelvis, commonly known as a 'trauma series', to ascertain possible life-threatening injuries. (Where available, a CT trauma series for head, neck, thorax, abdomen and pelvis may be the imaging modality of first choice). Examples would be a fractured cervical vertebra, a severely fractured pelvis, or a haemothorax. Once this initial survey is complete, x-rays may be taken of the limbs to assess the possibility of other fractures. It also is quite common in severe trauma for patients to be sent directly to CT or a surgery theatre, if they require emergency treatment. Extracorporeal membrane oxygenation (ECMO) may be effective in treating some polytrauma patients with pulmonary or cardiopulmonary failure.

Military medicine

Polytrauma often results from blast injuries sustained from improvised explosive devices, or by a hit with a rocket-propelled grenade, with "Improvised explosive devices, blasts, landmines, and fragments account[ing] for 65 percent of combat injuries ...". The combination of high-pressure waves, explosive fragments, and falling debris may produce multiple injuries including brain injury, loss of limbs, burns, fractures, blindness, and hearing loss, with 60 percent of those injured in this way, having some degree of traumatic brain injury. In some respects, the high incidence of polytrauma in military medicine is, in fact, a sign of medical advancement. In previous wars most soldiers with such multiple injuries simply did not survive, even if quickly transferred into hospital care. Today many polytrauma victims never fully regain their previous physical capacity, and are more susceptible to psychological complications, such as PTSD.

U.S. treatment

As of 2013, there were five rehabilitation centers in the U.S. specialising in polytrauma. They are managed by the United States Department of Veterans Affairs and are located in Minneapolis, Minnesota; Palo Alto, California; Richmond, Virginia; San Antonio, Texas, and Tampa, Florida. In addition to the intensive care, insofar as still required, these hospitals mainly specialize in rehabilitative treatment. In addition the Department of Veterans Affairs has 22 polytrauma network sites, located throughout the country. Veterans Health Administration (VHA) developed a screening and evaluation process to ensure that OEF/OIF/OND Veterans with TBI are identified, and that they receive appropriate treatments and services. This includes mandatory screening for deployment-related TBI of all OEF/OIF/OND Veterans upon their initial entry into VHA for services. Veterans with positive screens are referred for a comprehensive evaluation by TBI specialists for diagnostic and treatment recommendations. Based on extensive research, the VA-TBI Screening Tool has revealed high sensitivity and moderate specificity allowing VA to identify symptomatic Veterans and develop an appropriate plan of care. From 2007 to 2015, over 900,000 Veterans have been screened for possible OEF/OIF/OND deployment related TBI. Of those, approximately 20 percent had positive screens and were referred for further evaluation. [1]

Epidemiology OEF/OIF/OND veterans have a high polytrauma rate. Respectfully, a study exhibited findings with a population of 16,590 OEF/OIF/OND veterans, in which 27.66% met the criteria for poly trauma. Those within this subpopulation were most likely male (92.9%) and White (71.0%). Similar findings in a sample of 2,441,698 OEF/OIF/OND active duty found that the rate of poly trauma was 5.99 per 1,000 individuals. Of those with polytrauma, 52.15% were most likely between the ages of 20–29 years, male (89.93%), White (69.07%), married (64.18%), and enlisted in the Army (74.71%). Furthermore, the rate of polytrauma among a sample of 613,391 OEF/OIF/OND veterans was 6% (36,800). Additional research has concluded that in a selection of 340 OEF/OIF/OND veterans, 42.1% exhibited symptoms of poly trauma. As of April 2007, the Department of Veterans Affairs has treated more than 350 service members in their inpatient centers.

The treatment and rehabilitative care for polytrauma patients is a very extensive and time-consuming activity. The recommended staffing numbers (FTE = Full Time Equivalent) for six rehabilitation treatment beds are:

In other words, 2.8 people are required full-time (24h), for every patient, often for months, while some care may be required for life.

References

Worked examples

Example 1 — a first encounter with Polytrauma

Start with the simplest possible case. Write down what Polytrauma claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Polytrauma before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Polytrauma ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Polytrauma

In research: Polytrauma appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Polytrauma in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Polytrauma is common in secondary-school and first-year university syllabi. It links to neighbouring topics Medical emergencies, Traumatology, Types of trauma, so understanding it makes those chapters shorter.
In everyday life: Look for Polytrauma outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

How to study Polytrauma in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Polytrauma means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Polytrauma out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Polytrauma in simple terms?

Polytrauma and multiple trauma are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries, such as a serious head injury in addition to a serious burn. The term is defined via an Injury Severity Score (ISS) equal to or greater than 16.

Why does Polytrauma matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Polytrauma?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Polytrauma.