IDENTIFICATION OF SEVERE TRAUMA

IDENTIFICATION OF SEVERE TRAUMA

The severely injured patient, with multiple injuries to di ff er ent body systems, poses unique diagnostic and treatment challenges. The early assessment and management of severe trauma begins in the prehospital environment. Many of these patients will be easily identified at the scene of injury Forewarning the receiving hospital allows the activation of the trauma team to prepare for the patient’s arrival. Key informa tion in the pre-alert includes basic demographic information (age and gender), mechanism of injury , injuries identified and vital signs, including respiratory rate, pulse, blood pressure and Glasgow Coma Scale (GCS). Pa tients who are identified before reaching hospital as having sustained, or are at high risk of sustaining, severe multisystem trauma should generate trauma team activ in the receiving hospital. It should be noted that not all patients with severe multisystem trauma are immediately obvious. An older adult patient falling down a few steps can easily sustain a hip fracture, multiple rib fractures and a small subdural haemorrhage. At first glance the patient can appear well, but their injury severity score (ISS) and potential mortality could easily exceed those of a younger patient with multiple open long bone fractures. Both patients are critically injured and should be managed with the same principles in mind. IDENTIFICATION OF SEVERE TRAUMA

The severely injured patient, with multiple injuries to di ff er ent body systems, poses unique diagnostic and treatment challenges. The early assessment and management of severe trauma begins in the prehospital environment. Many of these patients will be easily identified at the scene of injury Forewarning the receiving hospital allows the activation of the trauma team to prepare for the patient’s arrival. Key informa tion in the pre-alert includes basic demographic information (age and gender), mechanism of injury , injuries identified and vital signs, including respiratory rate, pulse, blood pressure and Glasgow Coma Scale (GCS). Pa tients who are identified before reaching hospital as having sustained, or are at high risk of sustaining, severe multisystem trauma should generate trauma team activ in the receiving hospital. It should be noted that not all patients with severe multisystem trauma are immediately obvious. An older adult patient falling down a few steps can easily sustain a hip fracture, multiple rib fractures and a small subdural haemorrhage. At first glance the patient can appear well, but their injury severity score (ISS) and potential mortality could easily exceed those of a younger patient with multiple open long bone fractures. Both patients are critically injured and should be managed with the same principles in mind.