الفهرس 
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Abstract
Summary
Polytrauma is considered one of the most important
causes of morbidity and mortality all over the world.
Many of polytrauma patients have to be admitted to
the intensive care unit, the managemenet of these patients
requires the intensice care back-up facilities.
Advanced Trauma Life Support (ATLS) is designed
to improve the way of treatment of such patients achieved
by “Trauma Team” which made up of group of doctors,
nurses, operation department assistants and radioghraps.
The aim of the trauma team is to provide a safe and
efficient evaluation of the patient identify all injuries and
instigate definitive management of such injuries.
Scoring systems in trauma patients can improve
outcome of the traumatized patients.
It‟s classified to physiological, anatomical and
combined (physiological and anatomical scores).
Early management of polytrauma patients is divided
to primary and secondary survey.
A- Primary Survey this can be summarized as first five
letters of English alphabets (ABCDE)
Airway with cervical spine control.
Summary
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Breathing.
Circulation.
Disability.
Exposure and environmental control.
B- Secondary Survey
Is a head to toe examination for presence of other
non-life threatening injuries.
The main guidelines for management of polytrauma
patients include:
Airway and ventilation management.
Evaluation and treatment of the circulatory state.
Initial neurologic evaluation of the trauma patient.
Missed injuries and tertiary survey.
Other considerations during the first day.
Advanced Trauma Life Support (ATLS) and
Sequential Trauma Educational Programs (STEPs) have a
great role to improve polytrauma patients management.
(ATLS) is now widely accepted as the standard of
care for initial assessment and treatment in trauma centers.
The premise of the (ATLS) program is to treat the greatest
threat to life first. It also advocates that application of
Summary
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indicated treatment for life threatening injury, with the
most time-critical interventions performed early.
In critical care, the monitoring is essential to the
daily care of ICU patients, as the optimization of patient‟s
hemodynamic, ventilation, temperature, nutrition, and
metabolism is the key to improve patients’ survival. Indeed,
the decisive endpoint is the supply of oxygen to tissues
according to their metabolic needs in order to fuel
mitochondrial respiration and, therefore, life. In this sense,
both oxygenation and perfusion must be monitored in the
implementation of any resuscitation strategy. The emerging
concept has been the enhancement of macrocirculation
through sequential optimization of heart function and then
judging the adequacy of perfusion/oxygenation on specific
parameters in a strategy which was aptly coined “goal
directed therapy.” On the other hand, the maintenance of
normal temperature is critical and should be regularly
monitored. Regarding respiratory monitoring of ventilated
ICU patients, it includes serial assessment of gas exchange,
of respiratory system mechanics, and of patients’ readiness
for liberation from invasive positive pressure ventilation.
Also, the monitoring of nutritional and metabolic care
should allow controlling nutrients delivery.