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While trauma surgery itself is a separate branch of surgical care, many general surgeons treat patients that have traumatic injuries. Traumatic injuries are the result of blunt force. Patients may have injuries like gunshot wounds, traffic crashes, burns, and stabbings. Pedestrians hit by cars, crushing and sports injuries, and injuries from falls also cause traumatic injuries.
Recommended Dallas-Fort Worth Traumatic Injury Doctors
Other minor traumatic injuries include:
- Strains and sprains
- Animal bites
- Electrical injuries
Other major traumatic injuries include:
- Subdural hematoma
- Traumatic brain injury
- Subarachnoid hemorrhage
- Spinal cord injury
- Hypovolemic shock
- Electrical injury
- Facial trauma
- Myocardial contusion
- Acoustic trauma
- Collapsed lung
- Puncture wounds
- Skull fracture
- Dislocated or broken jaw
- Multiple trauma injuries
Trauma injuries can affect any part of the body. It ranges from minor (slicing a small cut with a knife that needs stitches) to major (falling from a tall building). These injuries may induce systemic shock thus requiring immediate interventions and resuscitations to save the patient.
Interestingly, trauma is the primary cause of death for people 45 years old and younger. It’s the fourth leading killer for people of all ages. Around 60 million injuries happen every year in the U.S., and about 30 million need medical care. Of those, 3.6 million require a hospital stay.
In 2005, there were 2.7 million injuries, and 43,443 deaths resulting from motor vehicle crashes in the United States. Globally, 1.2 million people die in traffic crashes annually. Ninety percent of deaths from these crashes occur in the middle or low-income countries.
Traumatic injuries vary in severity as mentioned earlier. Breaking a bone or slicing a finger open on something metal can be very painful. However, the person usually just requires treatment from a general practitioner, emergency room, or clinic.
When a traumatic injury is severe, admission to the hospital for further assessment and treatment may be necessary. Rehabilitation might be another requirement. Tests show how serious the injury issue is and then determines the next steps.
The ISS or injury severity score is used to calculate the severity of the injury. Once every injury is diagnosed, the score is retrospectively calculated. Injuries severe enough may require intensive care or a special treatment plan. The injury severity score classifies injuries in all of the body regions according to an ordinal scale.
The body regions are:
- External area
The scale is:
- Maximal (untreatable)
Some Causes of Traumatic Injuries
- Burns and Fires
- Other types of physical assaults
- Other traumatic and shocking experiences
- Natural disasters, floods, and earthquakes
Surgeons that Perform Surgery on Traumatic Injuries
Trauma teams usually consist of a trauma surgeon, general surgeon, orthopedic surgeons, vascular surgeons, and others as needed, especially if the injury is severe. General surgeons typically repair the internal abdominal injuries, orthopedic surgeons fix any broken bones, and vascular surgeons repair damaged blood vessels.
In addition to surgeons, other team members may include; paramedics to transport and stabilize the injured patient, an anesthetist, nurses, a respiratory therapist, a radiographer, as well as support from scientists in the medical lab.
After the general five-year residency is completed, trauma surgery fellowships last approximately two years and often they serve as critical care fellowship, too. Surgeons must also take boards in surgical critical care.
Trauma Surgery Procedures Before Operations
When a trauma patient arrives at the hospital, they are assessed in the emergency room to evaluate the severity of their injuries. They prioritize the most life-threatening injuries. Stabilization and resuscitation are the most essential priorities before surgery unless its necessary to save the individual’s life. Next, is definitive surgical therapy.
CT-scans, MRIs, and X-rays are used to see how extensive the injuries to the patient are. They allow the surgeons to see internal bleeding and damage to the internal organs.
The most important factors to control are circulation, breathing, airway patency, and drugs necessary to stabilize the patient. Nurses and staff obtain the age, history, pre-existing conditions, and vital signs as part of triage care when the person is admitted. Other necessary tests like blood and lab tests may be performed as well as IV lines and monitoring equipment.
ER doctors and trauma surgeons have different skillsets. The emergency room doctor assesses, stabilizes, examines, and orders tests and images of the patient. If specialists are needed, the ER doctor alerts them. The emergency room physician also deals with admitting and discharging patients with the proper treatment and referrals for follow-up.
If a patient’s traumatic injuries require surgery, then the trauma surgeon takes over. This doctor follows the patient from the surgery through recovery and rehabilitation, as well as discharge. Sometimes if the patient requires emergency surgery, the operation may occur at the hospital that they arrived at or they could be transported to a hospital with the specialists needed.
Trauma surgery requires addressing things in a certain order. First, stop the bleeding and prevent any contamination that may be leaking from holes in the gastrointestinal system. After that, depending on the stability of the patient you operate on the injuries to address the patients needs or send them to the critical care unit.
The United States trauma guidelines were created in 1976. All hospitals are now accredited and identified as either Level I, II, III, or IV trauma medical centers based on the type of care that they provide. The level is also based on the volumes of people that they serve, whether they are rural or urban. This system is efficiently designed to accommodate disasters and mass casualties.
Trauma centers that are level I provide the highest level of patient care with 24-hour staffing, optimal capabilities, and resources. They are monitored on a regular basis to ensure that the facilities meet the national standards set. Level I trauma facilities must admit a set number of seriously injured patients every year. Patients treated at Level I centers have an increased survival chance of 20-25 percent.