Emergency management of severe polytrauma with traumatic diaphragmatic hernia via EMSS: case report and literature review
Abstract
Introduction: Traumatic diaphragmatic hernia (TDH) frequently results from high-energy trauma and is commonly associated with severe polytrauma, presenting significant diagnostic challenges. This report highlights the role of an integrated emergency medical services system (EMSS) in managing these complex cases. Case Presentation: A 56-year-old male was admitted following a motor vehicle accident. Despite prehospital resuscitation by the EMSS team, he presented with decompensated hemorrhagic shock. Persistent cardiorespiratory instability prompted computed tomography (CT), which revealed left TDH, liver laceration, pulmonary contusion, and multiple fractures. The unified trauma team performed damage control surgery. Postoperatively, the patient developed severe acute respiratory distress syndrome (ARDS) in the emergency intensive care unit, requiring massive transfusion and advanced ventilatory support. After stabilization, he underwent definitive orthopedic surgery and recovered without significant sequelae. Discussion: TDH is easily overlooked in polytrauma patients due to a nonspecific presentation. Early diagnosis and surgical intervention are critical. The integrated EMSS model – featuring coordinated prehospital care, in-hospital resuscitation, damage control surgery, intensive care, and definitive surgery by a single team – was instrumental in achieving a successful outcome. This approach ensures continuity of care and reduces missed diagnoses. Conclusion: Timely…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Chaos and quantum thermalization
- The Dalton quantum chemistry program system
- Cord Blood Leptin and Adiponectin as Predictors of Adiposity in Children at 3 Years of Age: A Prospective Cohort Study
- Quantitative metabolomics by H-NMR and LC-MS/MS confirms altered metabolic pathways in diabetes
- Stable adiabatic quantum batteries
- A novel self-lipid antigen targets human T cells against CD1c(+) leukemias
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.