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What is trauma?

Trauma is a condition that a person encounters after a sudden onset of physical injury which requires immediate medical attention.

Traumatic injuries may be mild or severe, depending on the severity, the patient may be treated only in a hospital emergency or may require a trauma alert team with high level of appropriate care. Response to trauma may be embodied by an acute stress reaction, which is a short-lived reaction that develops following a traumatic event.

 

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What are the causes of trauma?

Traumatic injury may be as a result of motor vehicle accidents, sports injury, fall, a natural disaster that require medical care.

Road traffic accidents are the commonest causes of trauma.

What is polytrauma?

Polytrauma or multiple trauma is defined as the condition in which the patient has suffered multiple traumatic injuries. It has a high mortality and morbidity rates in both developed and developing countries.

What are the types of traumatic injury?

The commonest injuries due to trauma and accident include head injuries, chest and abdominal injuries, fractures,and dislocations.

Patients with severe brain injury can die even before they are brought to the hospital. Patients who survive the traumatic brain injury may often suffer from neuro-psychologic impairments and disabilities.

Blunt trauma to head and neck can lead to arterial injuries which may result in the development of stroke causing neurological disabilities. Among road traffic injuries, 30% of the deaths are due to blood loss and 10-20% of the deaths could be preventable with better control of bleeding.

There are various types of traumatic injury include but not limited to;

  • Acoustic Trauma-Injury to the inner ear due to very loud noise
  • Brain Injury trauma or skull fracture- Injury in the brain due to a violence or accident
  • Broken bone- Trauma of fractured or broken bones in the body due to accidents
  • Broken or dislocated Jaw-trauma due to fracture of the jaw bone or the jaw bone has moved out of its normal position
  • Burns- Trauma due to burn in the body part caused by fire, electricity or chemicals
  • Crush injury-Compression of the body due to a natural disaster or a deliberate attack
  • Concussion- A type of traumatic brain injury due to a sudden blow, a jerk or shock in the head, causing the head to move back and forth
  • Cuts and puncture wounds- trauma due to cuts from a sharp object
  • Collapsed lung- Also known as traumatic pneumothorax, is because of a sudden jerk on the chest where the air enters the space between the chest wall and the lungs
  • Electrical injury- A type of burn trauma that is caused due to an electric shock
  • Facial trauma- Injury of any part of the face such as the eye, the nose, the jaw
  • Hypovolemic shock- this is caused due to severe blood and fluid loss from the body, following an accident or deliberate attack
  • Myocardial contusion- Also referred to a bruised heart, caused due to a car accident or fall from a height
  • Spinal cord injury- Injury of any part of the vertebra, leading to a neurological deficit in daily activities
  • Subarachnoid haemorrhage- bleeding the space between the brain and the skull, it can be life-threatening
  • Subdural hematoma- a collection of blood between the covering and surface of the brain
  • Traumatic amputation- Trauma due to loss of a body part, mostly due to accidents

What are the signs of trauma injury?

The life of a traumatized person may not be the same. Some people may even undergo a condition known as PTSD (Post-Traumatic Stress Disorder).

 

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What should you do as a bystander in an accident?

As a bystander, quick thinking and action may help in saving someone’s life. You can help a victim of an accident by:

  • Checking and ensuring the person is brought to a safe situation or environment
  • Calling the ambulance and police
  • Providing withnecessary and possibly first aid assistance.

What are the investigations performed after a traumatic accident?

After the person is brought to the hospital, immediate investigations are to be done to assess the nature and extent of injuries. Some of the investigations include:

  • Blood tests
  • Imaging tests
  • Abdominal, Chest and Spine X-ray
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Ultrasound
  • Metabolic profile
  • Urine test

How is a traumatic accident managed?

Polytrauma is associated with significant complications and can, therefore, be life-threatening. The management of such patients requires rapid assessment and life-preserving management. These severely injured patients can be saved with efficient management and focused trauma care in tertiary care hospitals.

Polytrauma is a major cause of death worldwide. It has a high rate of mortality and morbidity. Patients with polytrauma would have injuries involving multiple body regions or cavities. Polytrauma management involves massive resuscitation, extensive imaging, multiple surgeries, hospitalization in intensive care units and complex rehabilitation programmes.

The most common trauma care followed after an accident is most commonly known as an ABCDE management which stands for;

 

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  • Airway- checking if the person is still responding or not.If not open the airway by lifting the chin with two fingers or suctioning can also be done. The person is placed in a neutral position with manual immobilization
  • Breathing-check if the person is still breathing or not by noticing the movement of the chest and pulse
  • Circulation- the persons’ heart and pulse rate are assessed. Performing a chest compression if the person is not breathing. In trauma victims, a fall in blood pressure is most common. Thereby fluid resuscitation a vital first intervention.
  • Disability and neurological status- Maintenance of adequate oxygenation and perfusion are the main goals of initial management to prevent secondary brain injury.
  • Exposure- Undress the person, however, prevent hypothermia

What do we need to do after a traumatic event?

Trauma can lead to improper functioning of activities. One should overcome the trauma by facing fears and be able to talk about what had happened.  Cognitive behavioural therapy (CBT) can help you overcome the nightmares of a traumatic event. CBT includes;

  • Acceptance- learning how to gradually accept the trauma-related memories
  • Cognitive restructuring- changing thoughts and fears about the traumatic incident
  • Deep breathing and relaxation
  • Education- the person should be aware that the signs and feelings are normal and that some time is required for recovery
  • Socializing with the surrounding environment
  • Talking to people

What are the rehabilitation procedure required after a traumatic event?

The objective of a rehabilitation program is to enhance the recovery duration and strengthened muscle strength and to reduce the problems of bed sores. The ultimate goal is to enable the patient to be able to perform their regular activities as before the traumatic event took place.Rehabilitation can include;

Physical rehabilitation- depending on the severity of the traumatic event, the patient will receive a physical rehabilitation procedure, which will include but not limited to;

  • Correct movement
  • Correct posture
  • Exercises
  • Education and training

 

Cognitive rehabilitation- It consists of diverse interventions and consists of two components;

  • Restorative approach- aims at restoring and strengthening impaired skills
  • Compensatory approach- aims at compensating for impaired skills

 

Disclaimer: The shared article is only for awareness and education purpose. Readers are advised to consult their doctor for proper evaluation of the condition and more information. Do not self-medicate.

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