The cumulative severity of this trauma load on the patients anatomy

and physiology is often expressed as an injury severity score (ISS)

of 16 or above and represents 1520% of the overall trauma
population. The ISS is calculated from the degree of injury severity
to the three most severely injured body regions. Polytrauma
patients have signifi cantly greater mortality and morbidity and
require complex multidiscipline medical management, prolonged
hospitalization, rehabilitation, and recovery periods. The social
and economical implications for the patient, his/her family, and
society in general, are immense.
The pathway of clinical interventions of patients with multiple
injuries is complex and involves input from a variety of medical
disciplines. The different steps of the pathway are as follows:
initial management at the scene of the injury and transport to a
medical facility, resuscitation room, diagnostics (radiological
investigations), operating room, intensive care unit, ward care,
in-hospital rehabilitation, and discharge home ( Fig 2.9-1 ). The
clinical management of the patient, however, continues even after
hospital discharge as many patients require additional rehabilitation