Multidisciplinary Trauma Care: The Role of BIS Monitoring, Lung Ultrasound, and Surgical Precision in Complex Extubation

Abstract

This case report presents a 24-year-old male who sustained multiple severe injuries from an assault involving a butcher’s knife, affecting his neck, left shoulder, and left lower leg. The patient arrived in hypovolemic shock with a Glasgow Coma Scale of 9, requiring urgent resuscitation and surgical intervention. Diagnostic imaging revealed a displaced tibia and fibula fracture, along with a contaminated deep neck wound posing significant risks to neurovascular and airway structures. Immediate management included aggressive fluid resuscitation, tranexamic acid administration, and prophylactic antibiotics, followed by multidisciplinary surgical repair of the neck musculature and orthopedic fixation of the fractures. Intraoperatively, the patient required extensive blood product transfusions and advanced pain management techniques, including a fascia iliaca block. Postoperative care emphasized infection prevention, hemodynamic monitoring, and early physiotherapy, resulting in a stable recovery without complications. This case highlights the challenges of managing complex trauma involving multiple anatomical regions, underscoring the importance of systematic assessment, surgical precision, and multidisciplinary collaboration in achieving successful outcomes.

Keywords: Trauma Care, surgical intervention, BIS Monitoring