Polytrauma Course (PTC)
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Home
Course Concept
History
Certificate
Trademark
COVID
Emergency Room Guideline
General Guideline by ESTES
Pathophysiology Trauma/COVID-19
Course
Upcoming Courses
Previous Courses
Teaching Award
Course Registration
Network
Forum
Contact
Education
ISS Calculator
Patient Assessment
Acute Trauma
Clinical Course (> 12 h)
App (free)
Online App Content
Books
References
Iss Calculator
Injury Pattern
Head/Face/Neck
No injury
Cerebral injury with headache; dizziness; no loss of consciousness
1
“Whiplash” complaint with no anatomical or radiological evidence
1
Abrasio and contusion of the ocular apparatus;vitreous or retinal hemorrhage
1
Cerebral injury with or without skull fracture, less than 15 minutes unconsciousness
2
Undisplaced skull or facial bone fractures or compound fracture of the nose
2
Laceration of the eye and apppendage; retinal detachment
2
“Whiplash” with severe complaints with anatomical or radiological evidence
2
Cerebral injury with or without skull fracture, more than 15 minutes unconsciousness; no neurologic signs
3
Displaced closed skull fractures without signs of intracranial injuries
3
Loss of eye or avulsion of the optic nerve
3
Displaced facial bone fractures or those with antral or orbital involvement
3
Cervical spine fractures without cord damage
3
Cerebral injury with or without skull fracture or abnormal neurological signs
4
Compound skull fracture
4
Cerebral injury with intracranial hemorrhage; signs of increased intracranial pressure; pupil inequality
5
Cervical spine injury with quadriplegia
5
Major airway obstruction
5
Fatal injury – unsurvivable
6
Chest
No injury
Muscle ache or chest was stiffness
1
Simple rib or sternal fractures
2
Major contusion of the chest wall without hemothorax or pneumothoras or respiratory embarassment
2
Multiple rib fractures without respiratory embarassment
3
Hemothorax or pneumothorax
3
Rupture of the diagram
3
Lung confusion
3
Open chest wound
4
Flail chest
4
Pheumomendiastinum; pericardal injuries
4
Myocardial contusion (ECG changes)
4
Chest injuries with respiratory embarrassment; laceration of the trachea or hemomediastinum
5
Aortic laceration
5
Myocardial rupture or confusion with circulatory embarrassment
5
Fatal lesion of th aorta or myocard
6
Abdomen
No injury
Muscle ache; seat belt abrasion
1
Major contusion of abdominal
2
Contusion of the abdominal organs
3
Extraperitoneal bladder rupture
3
Retroperitoneal hemorrhage
3
Avulsion of the ureter
3
Laceration of the uretra
3
Thoracic or lumbar spine fractures without neurological involvement
3
Minor laceration of intraabdominal organs (spleen, kidney, pancreas)
4
Intraperitoneal bladder rupture
4
Avulsion of the genitals
4
Thoracic and/or lumbar spine fractures with neurologic deficits
4
Repture, avulsion or severe laceration of intraabdominal vessels or organs
5
Fatal inujuries of intraabdominal vessel or organs
6
Extremity
No injury
Minor sprains and fractures and / or dislocations of digits
1
Undisplaced long bone of pelvic fractures
2
Major sprains of major joints
2
Displaced long bone fractures or multiple hand or foot fractures
3
Single open long bone fracture
3
Pelvic fracture with displacement
3
Dislocation of the major joints
3
Amputation of the digits
3
Laceration of the major nerves or vessels of extremities
3
Multiple closed long bone fractures
4
Amputation of the limb
4
Multiple open limp fractures
5
External
No injury
Minor laceration, confusion and abrasio
1
Extensive confusion; abrasion; large laceration
2
Burns of 10-20% body surface 2 degrees or 3 degrees
2
Extensive contusion; abrasion; large laceration on more than two extremities
3
Burns of 20-30% body surface 2 degrees or 3 degrees
3
Severe laceration and dangerous hemorrhage
4
Burns of 30-50% body surface 2 degrees or 3 degrees
4
Burns of more than 50% body surface 2 degrees or 3 degrees
5
Hemorrhage
Systolic blood pressure (mmHg)
100 mmHg or more
90 mmHg – 100 mmHg
60 mmHg – 90 mmHg
< 50 mmHg - 60 mmHg
Stable (GRADE l)
Blood Units
No
Yes
Systolic blood pressure (mmHg)
Lactate Levels
Normal range
Around 2.0 – 2.5
>2.5
Severe acidosis
Systolic blood pressure (mmHg)
Coagulopathy
Any sign of coagulopathy
No
Yes
Hypothermia
Temperature
> 35°C
33°C – 35°C
30°C – 32°C
30°C or less
Soft Tissue Injuries
Severe brain injury (AIS ≥ 3)
No
Yes
Chest trauma scores; AIS
No injury
AIS l or ll
AIS ll or more
AIS lll or more
AIS lll or more *
Abdominal trauma
No
Trauma without bleeding
Active bleeding
Pelvic Trauma (AO class)
Stable
Partially unstable
Unstable
AO Type A, YB LC
External (AIS)
No or AIS l
AIS ll – lll
AIS lll – lV
(e.g. abrasion)
Age
Age over 70 years?
No
Yes
Stable (GRADE l)
Finish
Final Report
ISS:
0
Recommendation