Trauma

Trauma occurs when a person experiences a sudden or violent injury. Safety and prevention of injury should be foremost in people's minds. It is easier to prevent than to treat trauma.

Seat Belts Saved Marcus

Marcus was 16 years old and in a car with four other teenagers. The driver was going too fast, missed a curve, and smashed into a tree. The compact car flipped over, tossing the teens who were not wearing seat belts out of the car. Paramedics found Marcus conscious and still belted in the back seat with only a broken arm and leg. The four other passengers died. "Without them," Marcus said of seat belts, "I'd be dead."

What Is Trauma?

Trauma may be physical or psychological. Physical trauma is an injury or wound caused by external force or violence: motor vehicle accidents, falls, burns, drowning, elecric shock, stabbings, gunshots, and other physical assaults. Physical trauma may cause permanent disability, and it is the leading cause of death for people under age 40 in the United States. Even surgery is a trauma—it is planned and controlled, but the body reacts in many of the same ways.

The majority of deaths occur in the first several hours after trauma. Trauma also may cause psychological shock that produces confusion, disoriented feelings and behaviors, and long-term after effects.

Trauma Emergencies

Traumatic injuries may include broken bones, severe sprains, head injuries, burns, and internal or external bleeding. They may occur at any time, and they are medical emergencies that require immediate treatment.

Burns

Burns are tissue damage that results from scalds, fires, flammable liquids, gases, chemicals, heat, electricity, sunlight, or radiation. There are approximately 2 million burn injuries each year in the United States. Burn injuries may cause swelling, blistering, dehydration, infection, and destruction of skin and other body organs. Treatment of burns may require antibiotics, transfusions, and surgery.

Traumatic brain injury (TBI)

Traumatic brain injury is the form of trauma most likely to result in permanent disability or death, with gun injuries as the leading cause, followed by motor vehicle accidents, and falls. In the United States, estimates of the number of people affected by traumatic brain injuries each year include:

• 1 million people treated in hospital emergency rooms
• 230,000 people survive
• 80,000 people discharged with TBI-related injuries
• 50,000 people die.

Traumatic brain injuries affect many different parts of the body, and they may impair vision, memory, mood, concentration, strength, coordination, and balance. TBIs sometimes cause epilepsy and coma. They affect males about twice as often as females, with people between the ages of 15 and 24 at highest risk.

Shock

Shock may occur if the body's circulatory system shuts down as a result of trauma. Shock may result from internal or external bleeding, dehydration, vomiting, other loss of body fluids, burns, drug over-doses, severe allergic reactions, bacteria in the bloodstream (septic shock), and severe emotional upset. The symptoms of shock include cold and sweaty skin, weak and rapid pulse, dilated pupils, and irregular breathing. Doctors who treat trauma patients often begin transfusions of salt solutions to maintain fluid levels and blood pressure and prevent shock even before they treat other traumatic injuries.

Preventing Trauma

In the United States, trauma kills more people under age 40 than any other disease or medical condition. It is one of the most preventable cause of death. Preventive measures include:

• Motor vehicle seatbelts, restraints, and airbags
• Child safety seats for cars
• Bicycle helmets
• Home smoke detectors
• Firearm safety procedures
• Enforcement of vehicle, firearm, and workplace safety laws.

The Trauma May Last

Survivors of traumatic events, or other situations that involve intense fear and loss of control, are at risk for psychological problems in addition to their physical ones. Emotional support and counseling immediately after the trauma are important as people adjust to the sudden (and often irreversible) changes the trauma causes in their lives. If left untreated, they may develop post-traumatic stress disorder, which can interfere with activities of daily living long after physical wounds have healed. Signs and symptoms of ongoing psychological trauma include:

• Dreams, flashbacks, or intrusive thoughts during which people re-experience the traumatic event
• Avoiding places and people that remind them of the traumatic event
• Insomnia or difficulty concentrating
• Anxiety or depression
• Physical problems that did not exist before the trauma.

Preventing traumatic injury requires individual, group, and government attention to public health and safety.