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Sunday, October 12, 2008

Trauma

Trauma is serious physical injury to the body or mind, usually caused by violence, disaster, or negligent behavior such as driving while under the influence of alcohol or other drugs.

Note: Wikipedia does not provide medical advice. If you have a medical problem, you should seek expert help.

Physical trauma

In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death.

Trauma patients require specialized care including surgery and often blood transfusion within the so-called Golden Hour of emergency medicine, or sixty minutes. This time frame is not a strict requirement, but it serves to point out the critical first hours after the injury in which most deaths from trauma occur. To help ensure that injured people reach appropriate care in a timely manner, many areas have organized trauma referral systems. Research has shown that deaths from physical trauma decline in areas where organized trauma systems are implemented.

In the field, emergency medical technicians, nurses, and paramedics, 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. The purpose of the primary survey is to identify life-threatening problems. Ensuring that the injured person is not 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 perform a 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 bowel, bladder (urine), complete inspection of the body to find all injuries, and neurological exam. The purpose of the secondary survey is to identify all injuries so that they may be treated.

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 (i.e. hazardous chemicals or a spreading fire). Also see wilderness first aid if immediate emergency help is unavailable.

See also: emergency medicine - emergency medical service - trauma center - paramedic - nurse - surgery - fluid replacement

Psychological trauma

An other type of trauma is psychological trauma. It may accompany physical trauma, or exist independently. Typical causes of psychological trauma are abuse, violence, the threat of either, or the witnessing of either, particularly in childhood. Natural events such as earthquakes and volcanic eruptions can also cause psychological trauma. Man-made events such as armed conflict also inflict psychological trauma.

In times of war, psychological trauma has been known as shell shock and post-traumatic stress disorder. This is a specific syndrome in which the traumatized individual experiences nightmares, avoidance of certain situations and places, depression, and other symptoms. Post-traumatic stress disorder emerged as the label for this condition after the Vietnam War in which many men returned to the U.S. demoralized, and sometimes, addicted to drugs.

Psychological trauma is treated with therapy and, if indicated, psychotropic medications.

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