Polytrauma in emergency room

The aim of this article was to analyze last publications about polytrauma or severe trauma patients. We looked at mortality, treatment methods, severe hemorrhagic shock management in emergency department. According to the most current information from the World Health Organization (WHO), more than nine people die every minute from injuries or violence, and 5.8 million people of all ages and economic groups die every year from unintentional injuries and violence. Trauma and unintentional injuries remains the leading cause of death in persons 1 through 44 years of age. Based on „Berlyn definition“ – polytrauma significant is injuries of three or more points in two or more different anatomic AIS (The Abbreviated Injury Scale) regions in conjunction with one or more additional variables from the five physiologic parameters: hypotension (systolic blood pressure ≤ 90 mm Hg), level of consciousness (Glasgow Coma Scale [GCS] score ≤ 8), acidosis (base excesse ≤ 6.0), coagulopathy (international normalized ratio ≥ 1.4/partial thromboplastin time ≥ 40 seconds), and age (≥70 years). On these days trimodal distribution of death model is no more effective to describe deaths from severe trauma. Deaths related to trauma changed more to bimodal model, according to it, there is no more third peak of deaths. Polytrauma should be concern in prehospital care based on specific mechanism of injury, anatomic criteria, physiologic criteria and special considerations. Looking at The European guideline on management of major bleeding and coagulopathy following trauma, we can choose correct recomendations how a patient should be managed in prehospital care or emergency department, but the main goad is to find a bleeding source and do a damage control surgery or the definitive surgical repair depent on situation