Traumatic injury is a term which refers to physical injuries of sudden onset and severity which require immediate medical attention. The insult may cause systemic shock called “shock trauma”, and may require immediate resuscitation and interventions to save life and limb. Traumatic injuries are the result of a wide variety of blunt, penetrating and burn mechanisms. They include motor vehicle collisions, sports injuries, falls, natural disasters and a multitude of other physical injuries which can occur at home, on the street, or while at work and require immediate care.

Many accidents resulting in traumatic injury can be treated appropriately in hospital emergency departments. More severe and multiple traumatic injuries may be triaged by the 911 responding ambulance or helicopter flight teams as a Trauma Alert. A Level One Trauma Alert is a determination based on a rapid physical assessment of the victim’s immediate medical needs. Based on trauma alert criteria, first responders deliver the patient to the most appropriate hospital.

Trauma guidelines in the U.S. were first established in 1976, and an efficient sophisticated trauma network now serves us all wherever we live, work or travel. Hospitals are accredited and designated as Level I, II, III or IV Trauma Centers based on the care they are able to provide, as well as the volumes they serve, urban and rural. The trauma system is designed to accommodate mass casualties and disaster situations. Level I Centers provide the highest level of care with optimal resources and capabilities, staff and specialties around-the-clock, and are continuously monitored to assure that they meet or exceed national standards. Trauma centers work closely with their respective EMS systems so that care begins pre-hospital.

Critically injured patients deemed a Trauma Alert will be delivered to a resuscitation area which may look more like an operating room than a traditional emergency department. In this environment, a highly-skilled professional trauma team is ready to provide immediate life-saving procedures in state-of-the-art trauma bays. Research shows that getting to the right place at the right time, commonly known as the “Golden Hour” or first 60 minutes after the occurrence of a major multi-system trauma, is critical. Adult and pediatric trauma surgeons, trauma staff and resources are ready and dedicated 24/7 to provide this unique level of response so that critically injured patients will have the best possible chance of survival and the least residual disability from their injuries.

Following care in the trauma resuscitation area at a Level One facility, patients may proceed to surgery, an intensive care unit or the trauma nursing floor, with all the resources and services of the hospital available in a true multi-disciplinary fashion. Patients brought to Level II-IV centers may remain at that hospital or be transferred to a higher level of care as appropriate.

Types of Traumatic Injuries

Some common type of traumatic injuries include, but are not limited to:

• Traumatic brain injury
• Spinal cord injury
• Spine fractures
• Amputation - traumatic
• Facial trauma
• Acoustic trauma
• Crush injury
• Concussion
• Broken bone
• Jaw - Broken or dislocated
• Skull fracture
• Cuts and puncture wounds
• Collapsed lung
• Myocardial contusion
• Burns
• Electrical injury
• Hypovolemic shock
• Subarachnoid hemorrhage
• Subdural hematoma

Injury Severity Score (ISS)

The Injury Severity Score is an established medical score to assess trauma severity. It correlates with mortality, morbidity and hospitalization time after trauma. It is used to define the term major trauma. The ISS classifies each injury in every body region according to its relative severity on a six point ordinal scale:

1. Minor
2. Moderate
3. Serious
4. Severe
5. Critical
6. Maximal (currently untreatable).

There are six body regions:

1. Head / Neck
2. Face
3. Thorax
4. Abdomen / Pelvis
5. Extremities
6. External

The official site is conducted by the AIS Committee of the Association for the Advancement of Automotive Medicine (AAAM): the address is http://www.aaam1.org/ais/.