Advances in polytrauma management in the emergency setting

Abstract

Background: Polytrauma, a major global health issue, poses significant challenges to healthcare systems worldwide due to its high mortality and disability rates. Despite advances in diagnostic and therapeutic approaches, trauma remains a leading cause of death, particularly from road traffic accidents and among the elderly. Traditional definitions and management strategies for polytrauma have evolved, now incorporating comprehensive criteria such as the Berlin definition. Aim: This review aims to provide an updated overview of polytrauma management in emergency settings, focusing on advancements and current practices in pre-hospital care, emergency department resuscitation, and subsequent rehabilitation phases. Methods: The review synthesizes recent research and guidelines related to polytrauma management, including pre-hospital care techniques, resuscitation strategies, and innovative approaches like Damage Control Orthopaedics (DCO) and Damage Control Resuscitation (DCR). Key areas of focus include airway management, hemorrhage control, and the management of trauma-associated coagulopathy. Results: Advances in polytrauma management include the implementation of the Advanced Trauma Life Support (ATLS) and Pre-Hospital Trauma Life Support (PHTLS) systems, which have improved outcomes by standardizing care protocols. The integration of DCO and the shift towards individualized care approaches, such as Prompt Individualized Safe Management (PRISM), have enhanced patient stabilization and recovery.