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Trauma

Definition

Trauma is a serious injury or shock to the body. It is caused by a physical force, such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors. This can cause the injuries to be greater than just physical ones.
Brain Trauma from Whiplash
Whiplash brain
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Causes

Some causes of trauma include:

Risk Factors

Trauma is more likely if you are aged 1-44 years. Other factors that may increase the chance of trauma include:

Symptoms

Symptoms depend on the type or extent of injuries. Symptoms may include:
In addition, the following psychological effects may occur in response to trauma:

Diagnosis

A medical team will assess your symptoms and medical history. A thorough physical exam will be done. It may include a chest exam, abdomen and pelvic exam, exam of extremities, and a neurologic exam. A psychological exam and/or suicide assessment may also be done.
Your bodily fluids may be tested. This can be done with blood tests.
Your vital signs may be tested. This can be done with:
Imaging tests can be used to evaluate the injured area. These may include:

Treatment

Treatment depends on the cause, severity, or location of the injury.

Immobilize and Stabilize the Injury

Severe injuries need to be immobilized to reduce the risk of further damage. Once this is complete, an assessment for life-threatening injuries or complications will be done. Stabilizing an injury may require:
  • Splinting or bracing
  • A breathing tube for a blocked airway
  • IV fluids
  • Mechanical ventilation to take over breathing
  • Nutritional support
  • Admission to the hospital for monitoring

Surgery

Some injuries may require surgery. This may be done immediately to sustain life or at a later time to repair damage. Examples of surgery may include:
  • Vascular surgery to control bleeding
  • Neurosurgery to repair the spinal cord, brain, and/or nerves
  • Creating a tracheostomy to restore or improve breathing—this may be temporary or permanent
  • Repairing or connecting broken bones with wires, screws, or plates
  • Reconstructive or plastic surgery
  • Debridement (removing dead tissue) and skin grafting for severe burns
  • Creating a urostomy or colostomy to restore bladder and bowel function—this may be temporary or permanent
Some procedures, such as fracture repairs, may be delayed until swelling resolves.

Recovery and Rehabilitation

For some, recovery may be short (days or weeks). For others, it may take a long time (months or years). This may include the use of assisted devices like a cane or wheelchair. Severe injuries, especially to the head, neck, and spinal cord, may require short- or long-term (or permanent) rehabilitation.
In general, recovery and rehabilitation includes one or more of the following:
  • Physical therapy—to maintain or regain as much movement as possible
  • Occupational therapy—to assist in everyday tasks and self-care
  • Respiratory therapy—to assist with breathing
  • Speech and swallowing therapy
  • Psychological therapy—to improve mood and decrease depression

Prevention

To help reduce your chance of trauma:

RESOURCES

Family Doctor—American Academy of Family Physicians http://familydoctor.org

National Safety Council http://www.nsc.org

CANADIAN RESOURCES

Canadian Association of Emergency Physicians http://www.caep.ca

Trauma Association of Canada http://www.traumacanada.org

References

Approach to the trauma patient. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries;-poisoning/approach-to-the-trauma-patient/approach-to-the-trauma-patient. Updated July 2015. Accessed December 28, 2015.

Majou R, Farmer A. ABC of psychological medicine: trauma. BMJ. 2002;325(7361):426-429.

Major trauma—emergency management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Accessed December 28, 2015.

Spinal cord injury—acute management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2015. Accessed December 28, 2015.

Spinal cord injury—chronic management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 18, 2015. Accessed December 28, 2015.

Trauma fact sheet. National Institute of General Medical Sciences website. Available at: https://www.nigms.nih.gov/Education/pages/Factsheet%5FTrauma.aspx. Updated November 2012. Accessed December 28, 2015.

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