Prehospital car of polytraumatized patient

Politrauma označava skup najtežih i najkompleksnijih ozljeda, uzrokovana je vrlo jakom silom. Definira se kao ozljeda pri kojoj su zahvaćene najmanje dvije tjelesne regije, pri čemu jedna od tih ozljeda ili kombinacija više njih ugrožava život bolesnika. Zbrinjavanje politraumatiziranog bolesnika je vrlo složen zadatak jer je potrebno djelovati brzo, efikasno i timski. Osnovni principi rada Hitne medicinske pomoći su spašavanje iznenadno ugroženog ljudskog života metodama osnovnog i naprednog održavanja života. Zbrinjavanje traumatiziranog bolesnika provodi se po načelu International Trauma Life Supporta (ITLS) čiji je začetnik dr. J. E. Campbell. Prilikom zbrinjavanja politraume na terenu, stanje bolesnika može se procijeniti na temelju mehanizma nastanka ozljeda. Mehanizam nastanka ozljede može biti takav da su prisutne ozljede koje ne uključuju ni jednu po život opasnu komponentu, može biti ciljani ili lokalizirani mehanizam ozljede te generalizirani. Procjena stanja bolesnika izvodi se po načelima ITLS sustava koji uključuju primarni pregled, sekundarni pregled i kontrolni pregled. Primarni pregled bolesnika uključuje već spomenutu procjenu mjesta događaja, početnu procjenu, brzi trauma pregled te potrebne postupke i odluke. Sekundarni ITLS pregled omogućava detaljno pregledavanje svih dijelova tijela i zbrinjavanje ozljeda koje nisu detektirane prilikom primarnog pregleda. Kod osobe koja je zadobila višestruke ozljede ili mehanizam ozljede upućuje na mogućnost ozljede kralježnice, potrebno je izvršiti imobilizaciju kako bi se spriječila mogućnost daljnjeg ozljeđivanja tijekom transporta. Kako bi se prilikom pristupanja ozlijeđenoj osobi koja je zadobila višestruke ozljede mogao odrediti stupanj politraume koriste se skale za procjenu. Najčešće korištene skale su ISS (Injury Severity Score) i AIS (Abbreviated Injury Scale). Rad na što kvalitetnijem zbrinjavanju politraume osigurava veću mogućnost preživljavanja i smanjenje posljedica koje se mogu odraziti na život bolesnika ali i zdravstveni sustav u cjelini.Polytrauma is a term that is used to describe the most severe and most complex injuries which are caused by very strong force. It is defined as an injury in which at least two regions of the body are affected , and one of those injuries or their combination threathens the patients life. Care of a polytraumatised patient is extremely complex because it requires fast, efficient and above all, team work. The basic principles of emergency medical service are rescuing a patient that is suddenly endangered, using methods of basic and advanced life support. The care for a traumatised patient is done by the principles of International Trauma Life Support (ITLS), which was founded by dr. J. E. Campbell. The condition of the patient on the field can be evaluated through the mechanism of the injury itself. The mechanism of the injury can be such so no injuries that are life threathening are present, it can be localised or generalised. The evaluation of the patient is done by the principles of ITLS that involve primary, secundary and control examination. Primary examination of the patient involves assessing the scene of the accident, initial assessment, quick trauma exam and the following decisions and procedures. The secondary examination allows us to thouroughly examin each body part and region and taking care of the injuries that were not detected during the primary examination. If a person has multiple injuries or the mechanism of the injury implies the possibility of spinal injury, it is necessary to immobilisate the patient in order to prevent further injuries during the transportation of the patient. To determine the severity of polytrauma, we use assessment scales. The most commonly used scales are ISS (Injury Severity Score) and AIS (Abbreviated Injury Scale). Working on the quality of care for polytrauma ensures better survival chances for the patient and reduction of life changing and life limiting consequences for the patient an consequences for the entire health care system