Introduction to Trauma Management

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Introduction to Trauma Management
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Trauma

• Leading cause of death ages 1-40
• Third leading cause in all age groups

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Trauma

• 50,000,000 injuries/year need medical attention
• 12 of all hospital beds occupied by trauma
• 22,000,000 bed-days/year accounted for by trauma
• 350,000 permanently disabled/year

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Trauma

• 100,000 to150,000 deaths/year
• 3,750,000 years of life lost--More than any other
  disease

Why does trauma account for more years of life
lost than any other disease?
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Trauma
One-fifth to one-third of all deaths may be
preventable
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Trauma Cost per Year
87,000,000,000
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Research Spending
15,000,000
550,000,000
1,000,000,000
Trauma The Neglected Disease of Modern Society
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Time to Care vs Survival
What do these numbers suggest about trauma care
strategies?
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When Trauma Deaths Occur
The Trimodal Distribution
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Immediate Deaths(lt1 hour)

• Loss of Airway
• Brain Stem Laceration
• High C-Spine Lesion
• Aortic/Heart Rupture

What can be done about these deaths?
What role does EMS play?
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Early Deaths (1-3 hours)

• Epidural Hematoma
• Subdural Hematoma
• Hemo/Pneumothorax
• Intra-abdominal Bleeding
• Pelvic Fractures
• Femur Fractures
• Multiple Long Bone Fractures

Why do these patients die?
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Late (2-4 weeks)

• Sepsis
• Multiple Organ System Failure

How can these deaths be avoided?
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Trauma Care Conclusions

• Definitive Trauma Care Surgeons Knife
• Short time to surgery Improved survival
• EMS improves survival by
• Recognizing critical trauma
• Supporting oxygenation, ventilation, perfusion
• Transporting rapidly to definitive care

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Where should the patient go?
The most appropriate facility
Not necessarily the closest one!