Care of the polytraumatised patient.

The treatment of patients with multiple injuries is challenging, but early optimal management is essential after trauma, since many life-threatening situations can occur. Any delay in diagnosis and treatment will contribute to long-term complications such as sepsis and organ failure and will increase late mortality (Regel et al 1996). The principles of the management of multiple trauma are early and simultaneous assessment and resuscitation, followed by a complete physical examination and diagnostic studies to establish the priorities for life-saving surgery (Trunkey 1991). We discuss trauma management in each of four different periods: 1) Acute or resuscitation (1 to 3 hours). 2) Primary or stabilisation (1 to 72 hours). 3) Secondary or regeneration (3 to 8 days). 4) Tertiary or rehabilitation (after the 8th day).