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Case Studies | Anaesthesiology | Volume 15 Issue 2, February 2026 | Pages: 1110 - 1111 | India
Navigating the Triple Threat: Anaesthetic Triumph in Polytrauma with Shock and Anticipated Difficult Airway
Abstract: Polytrauma represents one of the most demanding emergencies in anaesthetic practice, where rapid decision-making and coordinated multidisciplinary management are crucial for survival. We report the case of a 44-year-old woman with type 2 diabetes mellitus who sustained severe injuries following a pedestrian-bus collision. She presented in hypovolemic shock with a crush injury to the right lower limb and an anticipated difficult airway (Modified Mallampati Grade IV). The patient was classified as ASA IV (E). Initial resuscitation included aggressive fluid therapy, haemostatic support, broad-spectrum antibiotics, analgesia, and optimisation of glycaemic status prior to emergency surgical intervention. General anaesthesia was induced with ketamine to preserve haemodynamic stability. Invasive monitoring and central venous access were established, and a massive transfusion protocol was promptly activated, ensuring balanced blood product administration alongside targeted haemostatic resuscitation and active warming to mitigate the lethal triad of trauma-coagulopathy, acidosis, and hypothermia. Damage control orthopaedics, including external fixation and wound debridement, was performed to minimise operative duration and physiological insult. Postoperatively, the patient received structured intensive care management with mechanical ventilation, haemodynamic monitoring, and ongoing resuscitation. She was successfully extubated on postoperative day one and transferred to the ward on day four. This case highlights the importance of early airway preparedness, adherence to established trauma resuscitation principles, balanced transfusion strategies, and effective multidisciplinary coordination in achieving favourable outcomes in haemodynamically unstable polytrauma patients.
Keywords: Polytrauma, difficult airway, massive transfusion protocol, damage control surgery, hypovolemic shock, trauma resuscitation
How to Cite?: Dr. P. Monica, Dr. Uthkala B Hegde, Dr. Prasad K Kulkarni, "Navigating the Triple Threat: Anaesthetic Triumph in Polytrauma with Shock and Anticipated Difficult Airway", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 1110-1111, https://www.ijsr.net/getabstract.php?paperid=SR26217133711, DOI: https://dx.dx.doi.org/10.21275/SR26217133711