Management of polytrauma with early appropriate care in a tertiary care hospital

Abstract

Aim: Early​ appropriate care is to fix and stabilize the central skeletal system along with peripheral long bones of the skeletal system to reduce the risk of complications. Materials and Methods:​ This prospective observational study was carried out in the Department of Orthopaedics at Shri Krishna Medical College and Hospital Muzaffarpur, Bihar, India from December 2018 to June 2019. Total 110 patients with polytrauma were included in the study all were managed by Early Appropriate Care.  Results:​ Of the 110 patients with polytrauma, 85 (77.28%) were male and 25 (22.72%) female. Most of the patients 46(41.82%) with poly trauma were in the age group of 30 to 40 years, followed by 31(28.18%) above 40 years. Out of 110 patients managed using EAC protocol, 15 patients had major complications. 13 out of 15 cases developed fat embolism following surgical intervention as there was involvement of long bones and 2 patients developed deep vein thrombosis (DVT) and ultimately leading to pulmonary embolism (PE). All these cases were treated and managed in the intensive care unit (ICU) for an average period of around 10 days.  Conclusion: A low incidence of mortality seems to be associated with EAC protocol. Following adequate resuscitation and correction of acidosis early definitive fixation is possible for bony injuries of polytrauma patients which avoids the need of second surgery, also reduces the hospital stay duration, reduces postoperative complications and early rehabilitation protocols can be made.