Critical cases of trauma and severe injuries require timely and prudent management in the emergency department. Trauma, accidents and injury management places the highest burden on the emergency department.
A 17-year-old girl was brought to the emergency department of Apollo Speciality Hospitals, Vanagaram in an unconscious state. She had fallen from the second floor of a building and had severe blood loss. A bedside X-ray revealed severe injury to the pelvis and it was crushed and mangled. Given her grave condition, the emergency team at the Apollo Hospitals consisting of ER physicians, trauma care specialists, orthopedic surgeons, critical care specialists and nurses managed her aggressively.
Fracture of pelvis
Initially she was intubated, given a pelvic binding and her blood pressure was stabilized by transfusing adequate blood products to compensate the loss of blood. A bedside ultra-sonogram and a PAN CT were performed to evaluate the extent of her injuries. Apart from the pelvic fracture, she was also noted to have liver and chest injuries. Chest drains were placed in the emergency room to drain blood collected in the pleural space. Once the patient was hemodynamically stable, she was shifted to the critical care unit for further management. Her pelvis fracture was surgically fixed on the next day. Other injuries were managed conservatively. At discharge, the patient had made a full recovery from her injuries.
Management of a patient with severe injuries or trauma occurs in various phases. The initial phase of resuscitation and stabilization occurs in the emergency department. Further management involving critical care, surgery, conservative management, rehabilitation and follow-up care occurs beyond the emergency room. However, the outcome of the management and the prognosis of the patient depend heavily on the initial attention received in the emergency room.
The network of Apollo Hospitals, has always strived to provide high-quality, updated care in the management of patients with severe trauma. The expertise and technology available at Apollo Hospitals for management of accident and injuries are at par with international standards. The staff of the emergency department of every Apollo Hospital is judiciously chosen with sufficient numbers to tide over unforeseen situations like a mass casualty or disaster. Triage protocols are strictly adhered to and all urgent cases requiring life-saving interventions are attended to without delay. Additionally, the continued care of trauma patients with backup facilities like critical care and specialty care like surgery and orthopedics are also well coordinated. Consultants of all specialties are available on call and in-house as per the requirement.