Everything about Physical Trauma totally explained
» Treatment of physical trauma is described here and in First aid. For medical guidelines, see Guideline (medical).
Physical trauma refers to a
physical injury. A
trauma patient is someone who has suffered serious and life-threatening physical injury potentially resulting in secondary complications such as
shock,
respiratory failure and
death.
Specialized care
Definition
A body wound or shock produced by sudden physical injury, as from accident, injury, or impact. Trauma patients usually require specialized care, including
surgery and sometimes
blood transfusion, within the so-called
golden hour of emergency medicine, the first sixty minutes after trauma occurs. This isn't a strict deadline, but recognizes that many deaths which could have been prevented by appropriate care occur a relatively short time after injury. In many places organized trauma referral systems have been set up to provide rapid care for injured people. Research has shown that deaths from physical trauma decline where there are organized trauma systems.
Techniques
In a
prehospital setting, also called the "field",
emergency medical technicians,
paramedics, specialized
nurses, and less trained providers known as '
first responders', use
stabilization techniques to improve the chances of a trauma patient surviving the
ambulance trip to the
hospital. Professionals begin performing a
primary survey, consisting of assessment of airway, breathing, and circulation (called the "ABC's"). The purpose of the primary survey is to identify life-threatening problems. Ensuring that the injured person isn't disabled by unnecessary movement of the
spine is paramount, so the neck and back are secured before moving the patient. Unless the victim is in imminent danger of death, first responders will usually "load and go" transporting the victim immediately to the nearest appropriate
trauma-equipped hospital.
Upon completion of the primary survey, the
secondary survey is begun. This may occur during transport or upon arrival at the hospital. The secondary survey consists of a systematic assessment of the abdominal, pelvic and thoracic
viscera, complete inspection of the body surface to find all injuries, and
neurological exam. The purpose of the secondary survey is to identify all injuries so that they may be treated. A
missed injury is one which isn't found during the initial assessment (for example, as a patient is brought into a hospital's Emergency Department), but rather manifests itself at a later point in time, sometimes with baleful consequences (for example, a liver laceration is sometimes missed and a patient sent home, who will abruptly go into shock shortly thereafter.)
The appropriate
first aid for a trauma patient is to immediately
call for help using the
emergency medical service, then treat for
shock. Do not move the victim unless failure to do so would create a greater risk to their life (for example hazardous chemicals or a spreading fire). Also see
wilderness first aid if immediate emergency help is unavailable.
In case of traumatic accidents, health care providers use the ABC of life (airway, breathing and circulation) as their primary survey in identifying and assessing the condition of the patient. Airway is considered as the most important factor to be assessed then the breathing and circulation. From this technique the appropriate intervention will be identified immediately and prioritization of action can be done according to the most important aspect to be assessed
Efficacy
Time
Generally, the earlier a trauma patient can get specialized care, the greater are the chances of survival and recovery. However, there have been exceptions from this generalization.
For example in the
Falklands War the British military lost most of their helicopter support when the
Atlantic Conveyor was sunk by an Argentine
Exocet, resulting in no fast way to evacuate the wounded from the battlefield. Therefore any soldiers who suffered wounds lay where they fell in bitterly cold weather for hours with no blood transfusion, surgery or medication available. The opposite scenario was known from the
Vietnam War in which wounded
U.S. soldiers were usually quickly airlifted from the battlefield, kept warm and given aggressive medical treatment. The interesting statistic is that the casualty to fatality ratio in the Falklands War was still significantly lower than in the Vietnam War. Recently there has been some new research into how to treat physical trauma by comparing the different practices and experiences in these military conflicts. It might for example indicate that the environment is an important factor. For instance, in cold and barren areas, as around the
Falkland Islands, the risk that wounds become infected is smaller compared with warm and humid environments, as in the
rainforests of
Vietnam.
Further Information
Get more info on 'Physical Trauma'.
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