230:
of 2,441,698 OEF/OIF/OND active duty found that the rate of poly trauma was 5.99 per 1,000 individuals. Of those with polytrauma, 52.15% were most likely between the ages of 20–29 years, male (89.93%), White (69.07%), married (64.18%), and enlisted in the Army (74.71%). Furthermore, the rate of polytrauma among a sample of 613,391 OEF/OIF/OND veterans was 6% (36,800). Additional research has concluded that in a selection of 340 OEF/OIF/OND veterans, 42.1% exhibited symptoms of poly trauma.
171:
212:
Veterans Health
Administration (VHA) developed a screening and evaluation process to ensure that OEF/OIF/OND Veterans with TBI are identified, and that they receive appropriate treatments and services. This includes mandatory screening for deployment-related TBI of all OEF/OIF/OND Veterans upon their
157:
In some respects, the high incidence of polytrauma in military medicine is, in fact, a sign of medical advancement. In previous wars most soldiers with such multiple injuries simply did not survive, even if quickly transferred into hospital care. Today many polytrauma victims never fully regain their
229:
OEF/OIF/OND veterans have a high polytrauma rate. 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. Those within this subpopulation were most likely male (92.9%) and White (71.0%). Similar findings in a sample
216:
Based on extensive research, the VA-TBI Screening Tool has revealed high sensitivity and moderate specificity allowing VA to identify symptomatic
Veterans and develop an appropriate plan of care. From 2007 to 2015, over 900,000 Veterans have been screened for possible OEF/OIF/OND deployment related
82:, 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
599:
Ruff, Robert (2009-12-29). Faculty
Opinions recommendation of Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: polytrauma clinical triad (Report).
495:"Postdeployment Polytrauma Diagnoses Among Soldiers and Veterans Using the Veterans Health Affairs Polytrauma System of Care and Receipt of Opioids, Nonpharmacologic, and Mental Health Treatments"
90:. 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
1786:
1417:
213:
initial entry into VHA for services. Veterans with positive screens are referred for a comprehensive evaluation by TBI specialists for diagnostic and treatment recommendations.
1177:
748:
66:. This is because car crashes often occur at high velocities, causing multiple injuries. On admission to hospital any trauma patient should immediately undergo
182:
1455:
241:
is a very extensive and time-consuming activity. The recommended staffing numbers (FTE = Full Time
Equivalent) for six rehabilitation treatment beds are:
1283:
371:
1170:
1378:
1363:
1303:
1078:
550:
Cifu, David X.; Taylor, Brent C.; Carne, William F.; Bidelspach, Douglas; Sayer, Nina A.; Scholten, Joel; Campbell, Emily Hagel (2013).
317:
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.
101:
1776:
1473:
1163:
1083:
639:
1619:
1478:
1411:
1750:
1134:
393:
159:
233:
As of April 2007, the
Department of Veterans Affairs has treated more than 350 service members in their inpatient centers.
1257:
1240:
130:. The combination of high-pressure waves, explosive fragments, and falling debris may produce multiple injuries including
1860:
1234:
775:
743:
119:
1660:
1594:
1252:
1197:
181:
As of 2013, there were five rehabilitation centers in the U.S. specialising in polytrauma. They are managed by the
128:"Improvised explosive devices, blasts, landmines, and fragments account for 65 percent of combat injuries ..."
47:
209:. In addition the Department of Veterans Affairs has 22 polytrauma network sites, located throughout the country.
1781:
1577:
1572:
1523:
1098:
816:
401:
349:
712:
704:
493:
Adams, Rachel Sayko; Larson, Mary Jo; Meerwijk, Esther L.; Williams, Thomas V.; Harris, Alex H. S. (May 2019).
123:
1675:
1518:
1503:
1186:
943:
938:
54:. The term is generic, however, and has been in use for a long time for any case involving multiple trauma.
39:
1755:
1557:
1139:
948:
785:
780:
441:
Laughter, Sharon; Khan, Munziba; Banaag, Amanda; Madsen, Cathaleen; Koehlmoos, Tracey Perez (2021-05-29).
186:
131:
1870:
1865:
1760:
1681:
1127:
913:
873:
717:
687:
190:
104:(ECMO) may be effective in treating some polytrauma patients with pulmonary or cardiopulmonary failure.
31:
217:
TBI. Of those, approximately 20 percent had positive screens and were referred for further evaluation.
1612:
1432:
1088:
727:
632:
368:
298:
292:
219:
205:. In addition to the intensive care, insofar as still required, these hospitals mainly specialize in
1655:
1562:
1373:
1368:
1358:
1311:
1228:
1212:
923:
893:
552:"Traumatic brain injury, posttraumatic stress disorder, and pain diagnoses in OIF/OEF/OND Veterans"
170:
91:
1704:
1535:
1468:
1385:
1346:
1321:
1246:
1058:
1037:
996:
863:
198:
194:
1807:
1553:
1353:
1331:
1316:
1207:
908:
903:
858:
581:
573:
532:
514:
472:
464:
154:, with 60 percent of those injured in this way, having some degree of traumatic brain injury.
113:
95:
158:
previous physical capacity, and are more susceptible to psychological complications, such as
1665:
1336:
1053:
1017:
601:
563:
522:
506:
454:
286:
206:
414:
1691:
1589:
1463:
625:
397:
375:
310:
67:
30:, such as a serious head injury in addition to a serious burn. The term is defined via an
27:
26:
are medical terms describing the condition of a person who has been subjected to multiple
1802:
1645:
1422:
1110:
1105:
928:
795:
527:
280:
202:
71:
1854:
1530:
1513:
1144:
1027:
991:
986:
848:
790:
682:
304:
270:
143:
139:
1839:
1740:
1607:
1599:
1545:
1483:
1447:
1437:
1341:
1298:
1122:
1022:
981:
971:
966:
888:
672:
667:
151:
63:
494:
390:
510:
352:
Extracorporeal membrane oxygenation in severe trauma patients with bleeding shock
1822:
1745:
1326:
1093:
1032:
878:
800:
87:
75:
51:
35:
1829:
1812:
1724:
1640:
1584:
1001:
883:
722:
568:
551:
350:
http://www.resuscitationjournal.com/article/S0300-9572%2810%2900124-3/abstract
135:
606:
577:
518:
468:
459:
442:
1817:
1699:
1635:
853:
378:- Veterans Health Administration (VHA) Handbook, Thursday September 22, 2005
247:
175:
147:
34:(ISS) equal to or greater than 16. It has become a commonly applied term by
585:
536:
476:
443:"Prevalence of Polytrauma Clinical Triad Among Active Duty Service Members"
1155:
1719:
1670:
1650:
1508:
1427:
1202:
1117:
83:
1834:
1714:
238:
38:
physicians in describing the seriously injured soldiers returning from
1293:
1288:
837:
677:
648:
260:
4.0 FTE – Licensed
Practical Nurse and/or Certified Nursing Assistant
79:
254:
169:
1709:
1395:
976:
174:
One of the U.S. clinics specialising in polytrauma, this one in
43:
1159:
621:
118:
Polytrauma often results from blast injuries sustained from
1787:
European
Society of Paediatric and Neonatal Intensive Care
617:
391:
President's
Project: Support for VAMC Polytrauma Centers
266:
0.5 FTE – Clinical Case
Manager, Admission and Follow-up
62:
In civilian life, polytraumas often are associated with
1418:
Critical illness–related corticosteroid insufficiency
237:
The treatment and rehabilitative care for polytrauma
1795:
1769:
1733:
1690:
1628:
1544:
1496:
1446:
1404:
1273:
1266:
1221:
1071:
1046:
1010:
959:
836:
829:
809:
768:
761:
736:
703:
696:
655:
556:Journal of Rehabilitation Research and Development
1171:
749:Focused assessment with sonography for trauma
633:
8:
183:United States Department of Veterans Affairs
1270:
1178:
1164:
1156:
833:
765:
700:
640:
626:
618:
605:
567:
526:
458:
326:
98:, if they require emergency treatment.
499:Journal of Head Trauma Rehabilitation
386:
384:
364:
362:
360:
358:
16:Severe injuries from multiple traumas
7:
1666:Recombinant activated protein C
488:
486:
436:
434:
369:Polytrauma Rehabilitation Procedures
86:, a severely fractured pelvis, or a
1379:Multiple organ dysfunction syndrome
1364:Acute respiratory distress syndrome
1304:Multiple organ dysfunction syndrome
1079:Acute respiratory distress syndrome
340:, Volume 36, Issue 6, Pages 691-709
102:Extracorporeal membrane oxygenation
14:
1777:Society of Critical Care Medicine
1474:Ventilator-associated lung injury
1084:Chronic traumatic encephalopathy
1479:Ventilator-associated pneumonia
1412:Critical illness polyneuropathy
1135:Post-traumatic stress disorder
1:
1258:Geriatric intensive-care unit
1241:Pediatric intensive care unit
336:- Keel, M. & Trentz O. -
334:Pathophysiology of polytrauma
250:Discipline FTE Rehabilitation
1661:Neuromuscular-blocking drugs
1604:Nutritional supplementation
1235:Neonatal intensive care unit
776:Advanced trauma life support
744:Diagnostic peritoneal lavage
511:10.1097/htr.0000000000000481
120:improvised explosive devices
1761:Water-electrolyte imbalance
1595:Early goal-directed therapy
415:"Afghanistan/Iraq Veterans"
281:Speech-Language Pathologist
1887:
1613:Total parenteral nutrition
1546:Life-supporting treatments
1253:Critical illness insurance
111:
48:Operation Enduring Freedom
1782:Surviving Sepsis Campaign
1578:Ventricular assist device
1573:Intra-aortic balloon pump
1524:Pulmonary artery catheter
1193:
817:Resuscitative thoracotomy
705:Clinical prediction rules
569:10.1682/jrrd.2013.01.0006
402:American Legion Auxiliary
713:Abbreviated Injury Scale
607:10.3410/f.1366965.838063
207:rehabilitative treatment
124:rocket-propelled grenade
1676:Stress ulcer prevention
1620:Therapeutic hypothermia
1519:Central venous catheter
1187:Intensive care medicine
944:Penetrating head injury
939:Intracranial hemorrhage
305:Counseling Psychologist
276:0.5 FTE – Social Worker
263:0.5 FTE – Nurse Manager
40:Operation Iraqi Freedom
1751:Level of consciousness
1558:mechanical ventilation
1456:Methicillin-resistant
1140:Subcutaneous emphysema
1099:Volkmann's contracture
949:Traumatic brain injury
786:Early appropriate care
781:Damage control surgery
460:10.1093/milmed/usab199
293:Occupational Therapist
187:Minneapolis, Minnesota
178:
1458:Staphylococcus aureus
914:Thoracic aorta injury
874:Diaphragmatic rupture
718:Injury Severity Score
688:Trauma triad of death
191:Palo Alto, California
173:
122:, or by a hit with a
64:motor vehicle crashes
32:Injury Severity Score
1433:Stress hyperglycemia
1274:Organ system failure
1208:Medical specialities
1089:Compartment syndrome
728:Revised Trauma Score
299:Recreation Therapist
1861:Medical emergencies
1796:Related specialties
1756:Acid–base imbalance
1692:ICU scoring systems
1563:Tracheal intubation
1374:Respiratory failure
1369:Acute liver failure
1359:Acute renal failure
1229:Intensive care unit
1213:Respiratory therapy
924:Blunt kidney trauma
894:Pulmonary contusion
419:www.research.va.gov
185:and are located in
70:diagnosis of their
1705:Glasgow Coma Scale
1656:Intravenous fluids
1536:Screening cultures
1504:Arterial blood gas
1469:Refeeding syndrome
1386:Neonatal infection
1347:Vasodilatory shock
1322:Distributive shock
1247:Coronary care unit
1038:Spinal cord injury
997:Penetrating trauma
864:Soft tissue injury
453:(7–8): e856–e861.
396:2006-12-18 at the
374:2008-09-21 at the
287:Physical Therapist
257:(1.0 must be CRRN)
199:San Antonio, Texas
195:Richmond, Virginia
179:
28:traumatic injuries
1848:
1847:
1808:Internal medicine
1554:Airway management
1492:
1491:
1332:Obstructive shock
1317:Cardiogenic shock
1153:
1152:
1067:
1066:
909:Internal bleeding
904:Cardiac tamponade
859:Joint dislocation
825:
824:
757:
756:
447:Military Medicine
311:Neuropsychologist
221:
114:Military medicine
108:Military medicine
58:Civilian medicine
1878:
1569:Cardiac devices
1423:Decubitus ulcers
1337:Neurogenic shock
1271:
1180:
1173:
1166:
1157:
1059:Pediatric trauma
1054:Geriatric trauma
1018:Abdominal trauma
834:
766:
701:
642:
635:
628:
619:
612:
611:
609:
596:
590:
589:
571:
562:(9): 1169–1176.
547:
541:
540:
530:
490:
481:
480:
462:
438:
429:
428:
426:
425:
411:
405:
388:
379:
366:
353:
347:
341:
331:
255:Registered Nurse
218:
1886:
1885:
1881:
1880:
1879:
1877:
1876:
1875:
1851:
1850:
1849:
1844:
1791:
1765:
1729:
1686:
1646:Antithrombotics
1624:
1608:Enteral feeding
1590:Kidney dialysis
1540:
1488:
1464:Oxygen toxicity
1442:
1400:
1262:
1217:
1189:
1184:
1154:
1149:
1063:
1042:
1006:
955:
830:Pathophysiology
821:
805:
753:
732:
692:
651:
646:
616:
615:
598:
597:
593:
549:
548:
544:
492:
491:
484:
440:
439:
432:
423:
421:
413:
412:
408:
398:Wayback Machine
389:
382:
376:Wayback Machine
367:
356:
348:
344:
332:
328:
323:
315:
236:
227:
168:
116:
110:
96:surgery theatre
60:
24:multiple trauma
17:
12:
11:
5:
1884:
1882:
1874:
1873:
1868:
1863:
1853:
1852:
1846:
1845:
1843:
1842:
1837:
1832:
1827:
1826:
1825:
1820:
1815:
1805:
1803:Anesthesiology
1799:
1797:
1793:
1792:
1790:
1789:
1784:
1779:
1773:
1771:
1767:
1766:
1764:
1763:
1758:
1753:
1748:
1743:
1737:
1735:
1731:
1730:
1728:
1727:
1722:
1717:
1712:
1707:
1702:
1700:APACHE II
1696:
1694:
1688:
1687:
1685:
1684:
1679:
1673:
1668:
1663:
1658:
1653:
1648:
1643:
1638:
1632:
1630:
1626:
1625:
1623:
1622:
1617:
1616:
1615:
1610:
1602:
1597:
1592:
1587:
1582:
1581:
1580:
1575:
1567:
1566:
1565:
1550:
1548:
1542:
1541:
1539:
1538:
1533:
1531:Blood cultures
1528:
1527:
1526:
1521:
1516:
1506:
1500:
1498:
1494:
1493:
1490:
1489:
1487:
1486:
1481:
1476:
1471:
1466:
1461:
1452:
1450:
1444:
1443:
1441:
1440:
1435:
1430:
1425:
1420:
1415:
1408:
1406:
1402:
1401:
1399:
1398:
1393:
1388:
1382:
1381:
1376:
1371:
1366:
1361:
1356:
1350:
1349:
1344:
1339:
1334:
1329:
1324:
1319:
1314:
1307:
1306:
1301:
1296:
1291:
1286:
1281:
1280:Shock sequence
1277:
1275:
1268:
1264:
1263:
1261:
1260:
1255:
1250:
1244:
1238:
1232:
1225:
1223:
1219:
1218:
1216:
1215:
1210:
1205:
1200:
1198:Health science
1194:
1191:
1190:
1185:
1183:
1182:
1175:
1168:
1160:
1151:
1150:
1148:
1147:
1142:
1137:
1132:
1131:
1130:
1125:
1115:
1114:
1113:
1111:Rhabdomyolysis
1106:Crush syndrome
1103:
1102:
1101:
1091:
1086:
1081:
1075:
1073:
1069:
1068:
1065:
1064:
1062:
1061:
1056:
1050:
1048:
1044:
1043:
1041:
1040:
1035:
1030:
1025:
1020:
1014:
1012:
1008:
1007:
1005:
1004:
999:
994:
989:
984:
979:
974:
969:
963:
961:
957:
956:
954:
953:
952:
951:
946:
941:
933:
932:
931:
929:Splenic injury
926:
918:
917:
916:
911:
906:
898:
897:
896:
891:
886:
881:
876:
868:
867:
866:
861:
856:
851:
842:
840:
831:
827:
826:
823:
822:
820:
819:
813:
811:
807:
806:
804:
803:
798:
796:Trauma surgery
793:
788:
783:
778:
772:
770:
763:
759:
758:
755:
754:
752:
751:
746:
740:
738:
737:Investigations
734:
733:
731:
730:
725:
720:
715:
709:
707:
698:
694:
693:
691:
690:
685:
680:
675:
670:
665:
659:
657:
653:
652:
647:
645:
644:
637:
630:
622:
614:
613:
591:
542:
505:(3): 167–175.
482:
430:
406:
380:
354:
342:
325:
324:
322:
319:
314:
313:
307:
301:
295:
289:
283:
277:
274:
267:
264:
261:
258:
251:
243:
226:
223:
203:Tampa, Florida
167:
166:U.S. treatment
164:
109:
106:
72:cervical spine
59:
56:
15:
13:
10:
9:
6:
4:
3:
2:
1883:
1872:
1869:
1867:
1864:
1862:
1859:
1858:
1856:
1841:
1838:
1836:
1833:
1831:
1828:
1824:
1821:
1819:
1816:
1814:
1811:
1810:
1809:
1806:
1804:
1801:
1800:
1798:
1794:
1788:
1785:
1783:
1780:
1778:
1775:
1774:
1772:
1770:Organisations
1768:
1762:
1759:
1757:
1754:
1752:
1749:
1747:
1744:
1742:
1739:
1738:
1736:
1732:
1726:
1723:
1721:
1720:SAPS III
1718:
1716:
1713:
1711:
1708:
1706:
1703:
1701:
1698:
1697:
1695:
1693:
1689:
1683:
1680:
1677:
1674:
1672:
1669:
1667:
1664:
1662:
1659:
1657:
1654:
1652:
1649:
1647:
1644:
1642:
1639:
1637:
1634:
1633:
1631:
1627:
1621:
1618:
1614:
1611:
1609:
1606:
1605:
1603:
1601:
1598:
1596:
1593:
1591:
1588:
1586:
1583:
1579:
1576:
1574:
1571:
1570:
1568:
1564:
1561:
1560:
1559:
1555:
1552:
1551:
1549:
1547:
1543:
1537:
1534:
1532:
1529:
1525:
1522:
1520:
1517:
1515:
1514:Arterial line
1512:
1511:
1510:
1507:
1505:
1502:
1501:
1499:
1495:
1485:
1482:
1480:
1477:
1475:
1472:
1470:
1467:
1465:
1462:
1460:
1459:
1454:
1453:
1451:
1449:
1445:
1439:
1436:
1434:
1431:
1429:
1426:
1424:
1421:
1419:
1416:
1413:
1410:
1409:
1407:
1405:Complications
1403:
1397:
1394:
1392:
1389:
1387:
1384:
1383:
1380:
1377:
1375:
1372:
1370:
1367:
1365:
1362:
1360:
1357:
1355:
1354:Organ failure
1352:
1351:
1348:
1345:
1343:
1340:
1338:
1335:
1333:
1330:
1328:
1325:
1323:
1320:
1318:
1315:
1313:
1309:
1308:
1305:
1302:
1300:
1297:
1295:
1294:Severe sepsis
1292:
1290:
1287:
1285:
1282:
1279:
1278:
1276:
1272:
1269:
1265:
1259:
1256:
1254:
1251:
1248:
1245:
1242:
1239:
1236:
1233:
1230:
1227:
1226:
1224:
1222:General terms
1220:
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1188:
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1145:Wound healing
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1072:Complications
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1028:Facial trauma
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1016:
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992:Gunshot wound
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987:Electrocution
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849:Bone fracture
847:
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839:
835:
832:
828:
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791:Trauma center
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683:Resuscitation
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271:Social Worker
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136:loss of limbs
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1871:Trauma types
1866:Traumatology
1840:Traumatology
1741:Hemodynamics
1715:SAPS II
1682:Vasopressors
1600:Induced coma
1457:
1448:Iatrogenesis
1438:Stress ulcer
1390:
1342:Spinal shock
1299:Septic shock
1023:Chest injury
982:Crush injury
972:Blunt trauma
967:Blast injury
889:Pneumothorax
673:Traumatology
668:Major trauma
662:
594:
559:
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422:. Retrieved
418:
409:
345:
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329:
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273:Case Manager
235:
232:
228:
225:Epidemiology
215:
211:
180:
156:
152:hearing loss
132:brain injury
127:
117:
100:
61:
23:
19:
18:
1823:Pulmonology
1746:Hypotension
1641:Antibiotics
1484:Dialytrauma
1327:Anaphylaxis
1094:Contracture
1047:Demographic
1033:Head injury
879:Flail chest
801:Trauma team
88:haemothorax
52:Afghanistan
36:US military
1855:Categories
1830:Pediatrics
1813:Cardiology
1734:Physiology
1636:Analgesics
1585:Chest tube
1414:/ myopathy
1391:Polytrauma
1267:Conditions
1002:Stab wound
884:Hemothorax
810:Procedures
769:Principles
762:Management
723:NACA score
697:Assessment
663:Polytrauma
656:Principles
424:2022-09-29
400:(from the
321:References
309:0.5 FTE –
303:0.5 FTE –
297:0.5 FTE –
291:1.0 FTE –
285:1.0 FTE –
279:1.0 FTE –
269:1.0 FTE –
253:5.5 FTE –
246:0.5 FTE –
112:See also:
20:Polytrauma
1818:Neurology
1671:Sedatives
1651:Inotropes
1497:Diagnosis
960:Mechanism
854:Degloving
578:0748-7711
519:0885-9701
469:0026-4075
248:Physician
176:Palo Alto
148:blindness
144:fractures
1509:Catheter
1428:Fungemia
1203:Medicine
1118:Embolism
586:24458958
537:31058759
477:34050366
404:website)
394:Archived
372:Archived
239:patients
84:vertebra
1835:Surgery
900:Cardio
528:6546163
126:, with
1310:Other
1289:Sepsis
1243:(PICU)
1237:(NICU)
1011:Region
935:Neuro
838:Injury
678:Triage
649:Trauma
584:
576:
535:
525:
517:
475:
467:
338:Injury
201:, and
150:, and
80:pelvis
78:, and
1678:drugs
1629:Drugs
1312:shock
1249:(CCU)
1231:(ICU)
870:Resp
140:burns
94:or a
76:chest
68:x-ray
1725:SOFA
1710:PIM2
1556:and
1396:Coma
1284:SIRS
977:Burn
845:MSK
582:PMID
574:ISSN
533:PMID
515:ISSN
473:PMID
465:ISSN
160:PTSD
46:and
44:Iraq
22:and
1128:fat
1123:air
920:GI
602:doi
564:doi
523:PMC
507:doi
455:doi
451:187
50:in
42:in
1857::
580:.
572:.
560:50
558:.
554:.
531:.
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513:.
503:34
501:.
497:.
485:^
471:.
463:.
449:.
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433:^
417:.
383:^
357:^
197:;
193:;
189:;
162:.
146:,
142:,
138:,
134:,
92:CT
74:,
1179:e
1172:t
1165:v
641:e
634:t
627:v
610:.
604::
588:.
566::
539:.
509::
479:.
457::
427:.
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