Apollo Speciality Hospitals recently performed a successful management of severe multiple traumatic injuries on a 20 year old man who accidentally fell from the 17th floor of a construction site.
The procedure was conducted by a panel of doctors headed by Dr Roopesh Kumar, Senior Consultant Neurosurgeon, Dr Pratheema Ramachandran and Dr Devachandran Jayakumar, Critical care Consultants, Apollo Speciality Hospitals OMR.
Accidentally falling from the 17th floor the patient landed on the fifth floor of the building, sustaining multiple injuries in his body. He was immediately rushed to Apollo Specialty Hospitals, OMR for emergency treatment.
The patient who was brought in an unresponsive state, had breathing problems, extreme hypotension, and bleeding from the head, mouth, ears, and nose and both his legs had exposed bones.
Specialists at the emergency department immediately secured his airway and started artificial respiration, treating his hypotension with blood transfusion and IV fluids.
Once he was relatively stable, a whole-body trauma series CT scan was done which revealed severe traumatic brain injury with blood clots in his occipital lobes, multiple facial fractures, cervical spine fracture, liver and right kidney injuries with hemoperitoneum and both lower limb bone fractures. The patient was shifted to ICU for further management.
The patient was immediately sedated and paralysed to make his condition more stable. The team performed a tracheostomy to facilitate ventilation and administered medications to reduce brain swelling. Once his blood pressure got stabilised, his leg fractures were fixed through surgeries by orthopaedic surgeons and plastic surgeons. A team of urologists and gastroenterologists managed the patient’s liver and kidney injuries through non-operative procedures, said Dr Roopesh Kumar.
Subsequently, the patient’s damaged facial bones were surgically corrected by the faciomaxillary surgeon. Intermittent fever spikes were managed with antibiotics as per the guidance of the infectious disease consultant.
“He was shifted to rehabilitation unit and we continued with physiotherapy, speech and swallowing therapy. As his conscious level regained, he was behaving very aggressively with severe mood swings. This was managed by psychiatrist and neuropsychologist and he got normalised gradually.”added Dr Pratheema Ramachandran and Dr Devachandran Jayakumar during the press release.
After all the procedures the patient had significant stiffness of all four limbs which was becoming an obstacle to his rehabilitation. He was administered multiple spinal intrathecal injections of centrally acting muscle relaxants along with oral medications which aided in reducing the stiffness and helping in walking.
After nearly two months of intensive care management, multiple surgical procedures, various medications, physiotherapy, speech therapy, cognitive therapy, rehabilitation and nursing care at Apollo, the patient has now recovered well, said the team.