See a person having an injury like a road traffic accident, if he has an injury of a head having a head injury which needs a neurosurgeon, spine injury needing a spine surgeon then you know vessels injury that is blood vessels which needs a vascular surgeon, nerves injury needing a plastic surgeon, and then chest injury which might need a CT surgeon, bones fractured around which will need an orthopedic surgeon so this is teamwork.
Now you can have certain you can you must have seen some industrial injuries wherein the vessels are cut the hand is cut suddenly and the portion is severed like you have seen recently in one of the news where a policeman had the injury so in these scenarios you want a team of doctors to work together and you know they can do justice to the patient to bring back the organ to work to normalcy now along with this not only the things that you can see there are some things that are hidden inside like these soft structures like your lungs, your heart, your abdominal organs, you can have liver-kidney so a person can have multiple injuries hence we need a specialty center which deals with polytrauma Advanced Trauma life support (ATLS) is acute trauma life support and this is a training that is done for most of the western hospitals.
In London, it is an obligation that any surgeon should have this Advanced Trauma life support (ATLS) certificate the reason being we are being taught the sequence of attending to patients now we can have a patient who is bleeding in the leg at the same time is having difficulty in breathing now if surgeon concentrate on the bleeding leg that patient will die because of shortness of breath. So we are being trained to see how to make a patient survive so this is ATLS wherein we go stepwise from the airway to the other areas so that we don’t get distracted from the injuries that seem obvious but even a small bleeding wound might not take the patient’s life away but choke and patient not breathing for minutes or seconds can die so at our hospitals in Kukatpally they’re all trained in these techniques and we are trained to attend to the patients as a team so it’s usually the person having the major injury will be admitted in the primary surgeon who will take the lead and usually we have a round table discussion as to what are all the injuries that the patient has and then we call it triage is we want to see which area needs attention first now.
This is what is trained and this is what is taught in ATLS the person having a road traffic accident or any major injury first thing we should remember is there are some things that we can see and some things we don’t now we get a lot of patience we think you know the patient must have had some hand injury elbow injury or shoulder we try to constant areas and sometimes we might even ignore small things like fingers okay it’s just an example now i might have done a perfect operation for the long bones in the hand or the forearm and get perfectly healed and doctor might have missed a small finger injury or fingers later on the patient might have you know injury like that deformity where that is how the healing and if you imagine the right hand is most important for your day-to-day activity imagine a person like this and he is unable to do so we have to see the functional importance as well so if you come to a specialty center like Landmark Hospitals we are all trained like i discussed earlier like ATLS and the surgeons are trained to go as you know orderly fashion so that we don’t miss even the minute test of the injuries and there will be a person with a chart with a body diagram he’ll be taking all the injured organs whatever doubt we have we take an x-ray or the image of that area to make sure there is no injury not only the bones ligaments or like i said the vessels you can have internal organs wherein we have to do a CT scan or an ultrasound scan so at the end of the day we want to examine the patient as a whole jot down the injuries and then make a plan as to which is life threatening.
Now once if you come to a super specialty hospital like this where you have the senior-most well-trained surgeons in all the aspects not only surgeons you need physicians, you need anesthetist, it’s teamwork okay so we have a fantastic set of a team where they’re very well trained and the communication the most important thing is patient we want the life of the patient we have to plan accordingly what we do is we plan as to which needs attention. First like you know if the patient has a simple goal that goes into the heart it’s a no-brainer that needs attention fast rather than a bone which is fractured and the lip is dangling i would say mine is the last first you proceed so this is how we discuss we have a round table discussion and then we sort down and we also see is it safer to do all the surgeries at the same time or can we go step fashion there is something called secondary insect.
Now doing so many operations also can put the patient through so much trauma that he can’t withstand so we want to see the physiological reserve of the patient and the age group of the patient whether they can you know sustain this type of you know surgery they’re going to have and then plan accordingly not all injuries need surgery some just need splinting some needs observation so if you have a senior person with their experience they can decide which we can wait on if you have junior most there no I don’t find fault for them even I have come from a junior stage but they will be in a difficult situation to make a decision.
If they have a scenario like this having so many injuries so always it’s better that you have a senior consultant attending to you which we have at the super-specialty centers which have the polytrauma team we have very few centers in Hyderabad and in Telangana on the whole very few centers which can handle emergencies like this most important thing you should remember it is a patient’s life a quick decision taken in time is gonna save a patient’s life so you don’t want to run around to one or two hospitals have one you know specialty treating one area then you’re shifted to some other hospital treating that area you don’t want to run around if you want the patient there and the doctors running around the patient that is what you want there are very few centers having all these specialties together at one place so that is why at Landmark we are proud to say we have all these specialties available at one center and the senior-most consultants serving the patients.
