The tactics of traumatic disease treatment in patients with polytrauma at the resuscitation stage

Relevance. A clinical-and-tactical approach to treatment of patients with polytrauma still remains an unsolved problem. Specific challenges appear at the resuscitation stage. Purpose. To select clinical-and-tactical groups, as well as to make a retrospective analysis of lethality in every of them, as well as to determine the effect of the selected treatment tactics on this parameter. Materials and Methods. Screening based on more simple evaluation criteria, emphasizing the clinical-and-tactical groups of the patients admitted to the department of resuscitation and intensive care (DRIC). We used the data of clinical examination and diagnostic tests. The treatment tactics depended on trauma severity, and it was different in the emphasized groups. Results. We distributed the patients into groups on the basis of the cumulative estimation of injury character, delivery periods of time, somatic, neurological status. This allowed determining the approach to the selection of intervention character and scope at the resuscitation stage. Conclusion. The proposed division into five (5) clinical-and-tactical groups enabled to determine that no osteosynthesis types were acceptable for Group 1 patients (extremely severe). As for patients with less severe injuries and those in less serious condition (Group 2), it was admissible to perform osteosynthesis in them in the early periods. It is just in this group Damage control tactics is a perfect one regarding skeletal trauma. Osteosynthesis performing in Group 3 patients did not generally cause the critically significant level of second hit phenomenon. Fatal outcome occurred in only one person among those fourteen ones undergone surgeries of the locomotorium segments that amounted to 7.14 %. The lethality level in Group 4 patients is not associated with injury localization and character, but with the complications of the third period of traumatic disease (TD). And, at last, the lethality level in Group 5 patients expectedly turned to be 8 % that was due to more compensated condition of injured persons after preoperative preparation for the planned surgery.