You can find a summary of information on this topic in the text below. Detailed information is available in video lectures and recommended literature. 

Definition:

• Trauma is an injury caused by external forces. 
• Polytrauma is a serious trauma in which two or more organ systems are injured, and at least one of the injuries is life-threatening. 

Initial management 

Polytraumatic patients require an interdisciplinary approach in trauma centres. Managing polytrauma is challenging, e.g., imaging, many blood products, and experienced personnel. Polytraumatic patients should be transported to the trauma centre, ideally in less than 60 minutes.  

Pre-hospital care should be complex but fast, focused on securing the patient's airways (if indicated), stopping massive bleeding, immobilisation and transport to a trauma centre. The patient handover from EMS to the interdisciplinary team (anesthesiologist, surgeon, nurses, radiologist, etc.) should be structured, e.g., using MIST. 

Management in the trauma centre 

The ABCDE approach should be used in the primary survey. The absolute priority lies in stopping the massive bleeding. 

• A: Airway obstruction is one of the most frequent causes of death in trauma patients. Manoeuvres for opening airways, secret suctioning, oxygen application and securing the airways (if indicated) must be done immediately. BE CAREFUL: securing the airways could be challenging, and skilled physicians should be available. The rapid sequence induction method for aspiration prevention and manual in-line stabilization for C-spine injury prevention should be used. If indicated, the neck collar and headblocks should be applied.
• B: monitor SpO2 and titrate oxygen delivery accordingly. Look for signs of hemothorax, pneumothorax or flail chest (penetrating chest injury, crepitation, chest instability, diminished breathing sounds, asymmetry of chest excursion, paradoxical breathing,...), which are very frequent causes of respiratory failure in trauma patients.

• C: the main focus is on identification and treatment of the source of bleeding. Stopping the external massive bleeding has absolute priority, even before A and B. (Diagnostics and treatment of hemorrhagic shock are discussed in chapter Hemorrhagic shock). FAST - Focussed Assessment With Sonography for Trauma and full-body CT scan are the most frequent imaging methods in trauma patients. 

• Cannulation of at least two large peripheral cannulas or securing intraosseous access is indicated for volume therapy, hemo substitution, and vasopressors... Also, the labs should be performed (blood count, blood type, coagulation tests, lactate, ABG, ions...). The steps mentioned above are part of Damage control resuscitation, which aims for the prevention and treatment of trauma triad of death. If needed, the Damage control surgery should be performed immediately. The life-threatening condition typical for trauma patients is cardiac tamponade; its symptoms should also be looked for during "C" management and immediately treated. 

• D: basic neurological assessment focused on signs of traumatic brain injury (e.g. anisocoria, photoreaction...). If the GCS is less than 8 or AVPU is P or U, endotracheal intubation is indicated. 
• E: temperature management and secondary survey (head-to-toe physical examination), including log roll to check the patient's back side.