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Trauma
intermediate
X-Type

Polytrauma Management - DCO, ETC and the Second Hit Phenomenon

Polytrauma

A 28-year-old motorcyclist presents after a high-speed collision with an ISS of 35. He has bilateral femur fractures, a pulmonary contusion, and has required massive transfusion. His core temperature is 34°C, pH is 7.22, and INR is 1.8. The trauma team has completed the primary survey and achieved haemorrhage control. The orthopaedic registrar is asked whether the femurs should be nailed now or temporarily stabilized with external fixators. Regarding polytrauma management and damage control orthopaedics:

Mark each as TRUE or FALSE

A

Polytrauma is defined as ISS greater than 15; the LETHAL TRIAD of hypothermia, acidosis, and coagulo...

B

DAMAGE CONTROL ORTHOPAEDICS (DCO) involves temporary fracture stabilization (typically external fixa...

C

All polytrauma patients should receive immediate definitive internal fixation regardless of physiolo...

D

Patient categories guide treatment: STABLE patients (normal physiology) receive EARLY TOTAL CARE (ET...

E

Borderline criteria include: ISS greater than 40, bilateral femur fractures, pulmonary contusion, ma...

Answer the questions to see explanations

Click T (True) or F (False) for each option