A report on Major trauma

Health care providers attending to a person on a stretcher with a gunshot wound to the head; the patient is intubated, and a mechanical ventilator is visible in the background
Radiograph of a close-range shotgun blast injury to the knee. Birdshot pellets are visible within and around the shattered patella, distal femur, and proximal tibia
Whole body radiograph of traumatic injuries notable for fractures of both femurs (thigh bones), indicating major trauma
A Navy corpsmen listens for the correct tube placement on an intubated trauma victim during a search and rescue exercise
Typical trauma room
Incidence of accidents by activity in Denmark

Any injury that has the potential to cause prolonged disability or death.

- Major trauma
Health care providers attending to a person on a stretcher with a gunshot wound to the head; the patient is intubated, and a mechanical ventilator is visible in the background

10 related topics with Alpha

Overall

Cat scratches on an arm

Injury

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Any physiological damage to the human body caused by immediate physical stress.

Any physiological damage to the human body caused by immediate physical stress.

Cat scratches on an arm
Deaths from injuries per million persons in 2012
Deaths from intentional injuries per million persons in 2012
Burns by severity
A black eye, a common facial injury.
Types of bone fracture
CT scan of a brain hemorrhage (bottom arrow) and the surrounding edema (top arrow)
Trauma surgeons operating on a United States Marine

Major trauma is a severe traumatic injury that has the potential to cause disability or death.

Modern CT scanner

CT scan

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Medical imaging technique used to obtain detailed internal images of the body.

Medical imaging technique used to obtain detailed internal images of the body.

Modern CT scanner
Drawing of CT fan beam and patient in a CT imaging system
Computed tomography of human brain, from base of the skull to top. Taken with intravenous contrast medium.
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Bronchial wall thickness (T) and diameter of the bronchus (D)
Example of a CTPA, demonstrating a saddle embolus (dark horizontal line) occluding the pulmonary arteries (bright white triangle)
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Types of presentations of CT scans:
- Average intensity projection
- Maximum intensity projection
- Thin slice (median plane)
- Volume rendering by high and low threshold for radiodensity
Typical screen layout for diagnostic software, showing one volume rendering (VR) and multiplanar view of three thin slices in the axial (upper right), sagittal (lower left), and coronal planes (lower right)
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3D human skull from computed tomography data
Left image is a sinogram which is a graphic representation of the raw data obtained from a CT scan. At right is an image sample derived from the raw data.

CT scanning of the head is typically used to detect infarction (stroke), tumors, calcifications, haemorrhage, and bone trauma.

The Canadian C-spine rule for those with a normal Glasgow coma scale and who are otherwise stable

Clearing the cervical spine

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Process by which medical professionals determine whether cervical spine injuries exist, mainly regarding cervical fracture.

Process by which medical professionals determine whether cervical spine injuries exist, mainly regarding cervical fracture.

The Canadian C-spine rule for those with a normal Glasgow coma scale and who are otherwise stable
X-ray of normal congruous vertebral lines
CT scan of normal congruous vertebral lines.
CT scan with upper limits of the thickness of the prevertebral space at different levels.

It is generally performed in cases of major trauma.

Tranexamic acid

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A one gram ampoule of tranexamic acid

Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation.

Multiple organ dysfunction syndrome

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Altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis.

Altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis.

According to findings of Professor Zsolt Balogh and his team at the University of Newcastle (Australia), mitochondrial DNA is the leading cause of severe inflammation due to a massive amount of mitochondrial DNA that leaks into the bloodstream due to cell death of patients who survived major trauma.

A pelvic X-ray showing an open book fracture

Pelvic fracture

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Break of the bony structure of the pelvis.

Break of the bony structure of the pelvis.

A pelvic X-ray showing an open book fracture
Fractures of the superior (in two places) and inferior pubic rami on the person's right, in a person who has had prior hip replacements
Superior view, Pelvic Fracture Types (2006).
Force and break are shown by matching color:
Anteroposterior compression type I (orange), Anteroposterior compression type II (green), Anteroposterior compression type III (blue); Lateral compression type I (red), Lateral compression type II (purple), F. Lateral compression type III (black).
Increased force and breaks are shown by increasing size.
This fracture is best viewed anteriorly, while the other fractures are viewed superiorly. The arrow indicates where the force is coming from, and the colored lines indicate where the break occurs.

In younger people significant trauma is typically required while in older people less significant trauma can result in a fracture.

Drawing of internal and external bleeding from placental abruption

Placental abruption

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When the placenta separates early from the uterus, in other words separates before childbirth.

When the placenta separates early from the uterus, in other words separates before childbirth.

Drawing of internal and external bleeding from placental abruption
Ultrasound showing placental abruption.
Gross pathology of a uterus which has been opened to show a placental abruption, with a hematoma separating the placenta from the uterus.

Risk factors include smoking, pre-eclampsia, prior abruption (most important and predictive risk factor), trauma during pregnancy, cocaine use, and previous cesarean section.

Ambulances lined up in Tallahassee, FL prior to deployment during Hurricane Irma.

Emergency medical services

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Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care.

Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care.

Ambulances lined up in Tallahassee, FL prior to deployment during Hurricane Irma.
An ambulance in Lausanne (Switzerland) marked with multiple Stars of Life (representing emergency medical services).
Ambulance vehicle with the emblem of the Red Cross in Nizhny Novgorod, Russia.
Emergency medical services prepare to airlift the victim of a car accident to hospital, in Ontario, Canada.
A horse-drawn Bellevue Hospital ambulance in New York City, 1895.
A Royal Navy ambulance during World War I.
A 1973 Cadillac Miller-Meteor ambulance. Note the raised roof, with more room for the attendants and patients
A government-owned ambulance in Kyiv, Ukraine
A volunteer ambulance crew in Modena, Italy
Six points on the Star of Life
Training for EMS in Estonia.
Bags of medical supplies and defibrillators at the York Region EMS Logistics Headquarters in Ontario, Canada
A motorcycle ambulance in South Sudan.
Ambulances parked outside a local emergency room.
Ambulance in the Czech Republic
EMT staff at an emergency call in New York City
A patient arriving at hospital
EMTs loading a patient into an ambulance
A girl treated by a paramedic
A Toronto Critical Care ambulance
A Canadian STARS helicopter ambulance. Air ambulances often have staff who are specially trained for dealing with major trauma cases.
New York City Fire Department Haz-Tac Ambulance

They have a particular advantage for major trauma injuries.

A non-pneumatic anti-shock garment (NASG)

Shock (circulatory)

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State of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system.

State of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system.

A non-pneumatic anti-shock garment (NASG)
Effects of inadequate perfusion on cell function.
Epinephrine auto-injector
Sepsis mortality

Vasopressors have not been found to improve outcomes when used for hemorrhagic shock from trauma but may be of use in neurogenic shock.

Representation of the arterial pressure waveform over one cardiac cycle. The notch in the curve is associated with closing of the aortic valve.

Mean arterial pressure

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Average blood pressure in an individual during a single cardiac cycle.

Average blood pressure in an individual during a single cardiac cycle.

Representation of the arterial pressure waveform over one cardiac cycle. The notch in the curve is associated with closing of the aortic valve.
Arterial line

Both have been shown advantageous targets for sepsis, major trauma, stroke, intracranial bleed.