Key Priorities and Procedures for Stabilizing Polytrauma Patients: Airway Management and Hemorrhage Control in Severe Trauma

The stabilization of a polytrauma patient is a critical challenge in emergency medicine. Initial care in the emergency room serves as the essential link between field first aid and definitive treatment in the hospital. Rapid identification and management of life-threatening injuries are paramount to improving clinical outcomes and reducing mortality.

Primary Assessment and Key Procedures

The initial approach to managing a severe trauma case follows the A-B-C-D-E framework, prioritizing the primary assessment of airway, breathing, circulation, neurological deficits, and patient exposure. Airway management is crucial, especially in patients with craniofacial injuries, where obstruction may be imminent. Endotracheal intubation is often necessary to ensure adequate ventilation [1].

Hemorrhage control is another fundamental pillar. Massive hemorrhages, particularly in the thorax, abdomen, or pelvis, require rapid interventions such as emergency thoracotomy or laparotomy to control bleeding [2]. In cases of complex pelvic fractures, closing the pelvic space with external fixation devices and early angiography with embolization are effective strategies [3].

Initial stabilization of major fractures, especially in hemodynamically unstable patients, should be minimal and non-invasive, prioritizing hemorrhage control and temporary stabilization [4]. In hemodynamically stable patients, early internal fixation is recommended to reduce hospitalization time and associated complications.

Conclusions

Care for polytrauma patients must be structured and coordinated by a trauma team leader, ensuring that interventions are performed efficiently and in the correct order. The implementation of standardized protocols and the use of advanced technologies, such as contrast-enhanced computed tomography, are essential for a comprehensive and accurate assessment of injuries [5]. Interdisciplinary collaboration and ongoing training for medical staff are fundamental to improving outcomes in these complex patients.

Referencias

• [1] Multiple Trauma and Emergency Room Management
• [2] Initial care of the patient with blunt polytrauma
• [3] Damage control in orthopaedical and traumatology
• [4] Decision making and priorities for surgical treatment during and after shock trauma room treatment
• [5] Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study

Created 13/1/2025