Polytrauma

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. 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. 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: • 0.5 FTE – Physician Discipline FTE Rehabilitation • 5.5 FTE – Registered Nurse (1.0 must be CRRN) • 4.0 FTE – Licensed Practical Nurse and/or Certified Nursing Assistant • 0.5 FTE – Nurse Manager • 0.5 FTE – Clinical Case Manager, Admission and Follow-up • 1.0 FTE – Social Worker Case Manager • 0.5 FTE – Social Worker • 1.0 FTE – Speech-Language Pathologist • 1.0 FTE – Physical Therapist • 1.0 FTE – Occupational Therapist • 0.5 FTE – Recreation Therapist • 0.5 FTE – Counseling Psychologist • 0.5 FTE – Neuropsychologist 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==