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by Scholten A

Trauma

Definition

Trauma is a serious injury or shock to the body. It can affect a person's ability to function. Sometimes it can be fatal. It needs to be treated right away.
Brain Trauma from Whiplash
Whiplash brain
Copyright © Nucleus Medical Media, Inc.

Causes

Some causes of trauma include:
  • Accidents, such as:
    • Motor vehicle crashes
    • Falls
    • Plane crashes
  • Near-drowning
  • Physical assault—such as attacks, gunshots, stabbing, or rape
  • Burns and electrical shocks
  • Natural disasters—such as fires, floods, earthquakes, or lightning
  • Animal attacks
  • Contact sports
  • Explosions

Risk Factors

Trauma is more common in people aged 1 to 44 years. Other things that raise the risk are:
  • Lack of car or boat safety, such as:
    • Drinking alcohol while driving
    • Using a cell phone, texting, or being distracted while driving
    • Not wearing a seatbelt or a lifejacket
    • Not using a child safety seat properly
  • Improper use or storage of firearms
  • Unsafe home conditions such as:
    • Objects or conditions that lead to falls
    • Not using smoke detectors or not changing dead batteries
  • Not wearing proper protection—while playing sports or using dangerous equipment
  • Improper use of dangerous machinery
  • Fighting with fists or weapons—especially after drinking alcohol
  • Lack of water safety, such as:
    • Swimming alone or without previous lessons
    • Not watching a child while they are swimming
    • Improper fencing or locks around swimming pools
  • Approaching an animal unsafely or aggressively

Symptoms

Symptoms depend on the type or extent of injuries. They may include:
  • Pain
  • Bleeding
  • Breathing problems
  • Headache, nausea, vomiting, amnesia, or altered mental status
  • Deformity from broken bones
  • Loss of feeling and/or muscle strength
  • Problems urinating or passing stool
  • Loss of consciousness or coma
Emotional symptoms may be:

Diagnosis

A medical team will assess your symptoms and health history. A physical exam will be done. It may include an exam of the chest, belly, pelvic area, arms or legs. Tests may be done on the brain and nervous system.
Other tests may include:
  • A mental health exam
  • Blood tests
Imaging tests may be used to check the injured area. These may include:

Treatment

Treatment depends on the cause, severity, or location of the injury. Options may be:

Immobilize and Stabilize the Injury

Severe injuries need to be stabilized. This is to help reduce further damage. It may require:
  • Splinting or bracing
  • IV fluids
  • Being monitored in the hospital
  • A breathing tube for a blocked airway
  • Mechanical ventilation to take over breathing

Surgery

Some injuries may require surgery. This may be done right away or later. It depends on the severity of the damage. Examples are:
  • Surgery to control bleeding
  • Neurosurgery—to repair the spinal cord, brain, and/or nerves
  • Creating a tracheostomy—to help with breathing
  • Repairing or connecting broken bones with wires, screws, or plates
  • Reconstructive or plastic surgery
  • 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

Recovery and Rehabilitation

For some, recovery may be short (days or weeks). For others, it may take a long time (months or years).
In general, recovery and rehabilitation may include:
  • Physical therapy—to help with movement
  • 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 reduce depression

Prevention

There are many ways to reduce the risk of trauma. Learn about and practice:
  • Car safety and responsible driving
  • How to keep the home safe from fires, falls, and other accidents
  • Boat and water safety
  • Safety measures for recreation, sports, and using machinery
  • Child safety
  • Violence prevention
  • Responsible use of alcohol and certain medicines

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: https://www.merckmanuals.com/professional/injuries-poisoning/approach-to-the-trauma-patient/approach-to-the-trauma-patient. Accessed February 24, 2021.
Khellaf A, Khan DZ, et al. Recent advances in traumatic brain injury. J Neurol. 2019;266(11):2878-2889.
Major trauma—emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/major-trauma-emergency-management. Accessed February 24, 2021.
Management of chronic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-spinal-cord-injury. Accessed February 24, 2021.
Traumatic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/traumatic-spinal-cord-injury . Accessed February 24, 2021.
Trauma fact sheet. National Institute of General Medical Sciences website. Available at: https://www.nigms.nih.gov/Education/pages/Factsheet%5FTrauma.aspx. Accessed February 24, 2021.

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