Last year in March 2020, lockdown was announced and the roads were empty and so were the accident cases going down. Coming to July 2021, covid situation has not changed much but the roads are not empty this time. As a result, the road accident cases or road traffic accident (RTA) cases have increased which is one of the most common causes of polytrauma cases. India ranks no.1 is deaths due to RTA caused mainly by untreated polytrauma. The reason can be due to bad roads, not following traffic rules, speeding vehicles, poor visibility at night and less or no sign boards or any other. Most of the RTA cases are leads to polytrauma or can be fatal.
Polytrauma is used for severely injured patients with associated injuries i.e. 2 or more severe injuries in one area of body with the incidence of the traumatic shock or hemorrhagic hypotension with endangering one or more vital organ of the body.
We at RNH hospital have an experience team of doctors who manage polytrauma cases regularly. Advanced trauma life support (ALTS) protocol is followed for polytrauma cases by an accomplished team of doctors and nurses with primary objective being survival of the patient. ALTS include:
Primary survey-identify what is harming the patient
Resuscitation-treat what is harming the patient
Secondary survey-proceed to identify other injuries
Definitive care-develop a definitive management plan.
Let’s understand this better with a case scenario.
Patient named Mr.X (name cannot be revealed due to ethical reasons) was brought by an ambulance by his relatives with blood all over his body and arms. He was immediately shifted in a stretcher securing his cervical spine and all 4 limbs, checked his conscious status , vitals ,breathing and ventilation with circulation and looked for any fractures. After taking brief history from patient as he was conscious and detailed history with his relatives he was immediately shifted to ICU. His head, neck, thorax, abdomen and spine were surveyed while putting him on external O2 and inserting a urinary catheter. With some immediate X-ray , thoracic bleeding was detected which was taken care by intercostal drainage (ICD) tube insertion. There was intra-abdominal bleed also which was confirmed by USG, CT scan and Doppler study for which laparotomy was done in couple of days. Also fracture of his long bone was splinted as no vascular injury was involved with it and then operated in few weeks when his vitals were stable and he was fit for another surgery. Having no neurological damage or any head injury (luckily he was wearing a helmet) he cooperated very well with our team. With continuous monitoring of all vitals, nursing care, regular consultation with various doctors, rehabilitation it took him around a month to recover and gradually a 5-6 week time to walk on his own leg.
The whole RNH team shared immense happiness to seeing such polytrauma patients recover and walk back home.
RTA can be reduced if we follow few safety advises
Wearing helmet while riding 2 wheeler
Seat belt while driving 4 wheeler
Always drive within speed limit
Do not speed up on empty roads
Never break the signals
Do not overtake
Keep a safe distance from the vehicle ahead
Avoid drink and drive situations
Avoid night driving
Note -Here we have only discussed polytrauma caused by RTA, but polytrauma can also be due to fall from height, assault, airplane crashes, train derailment, blast or any chemical or thermal injury.