Emergency Care for Multiple Trauma

Overview  of multiple trauma

Emergency Care for Multiple TraumaThe term multiple trauma or multiple traumatic injuries are caused by a single disastrous event that causes life-threatening and morbid injuries to at least two or more distinct and vital organs/organ systems.  Mortality or possible permanent and non-reversible disabilities in victims are normally related to the degree of severity of the injuries and the number of organs/organ systems affected or damaged due to a catastrophic event. Following the events of a disaster which typically leaves an individual severely injured such as a vehicular collision, the body’s metabolism drastically increases becomes severely stressed out.

Immediate care to a victim with multiple traumatic injuries generally requires a professional and a team approach to significantly increase the chances of survival and recovery.  One member of the team is usually assigned and is responsible for coordinating the treatment and is usually the trauma physician who takes charge of the decisions within the team.  Other members of the emergency department include trauma nurses and other allied health personnel are tasked to assume the responsibility of assessing and constantly monitoring the patient, ensuring a patent airway and IV access, giving correct dosages of medications and making sure all life-support auxiliary devices and equipments are functioning well. Moreover, allied medical staff are responsible for collecting and examining laboratory specimens and documenting activities relative to the patient’s current condition.

Assessment and Diagnostic Procedures   

Gross evidence of trauma and multiple injuries can sometimes be slight and/or does not manifest any physical evidence. Individuals with multiple trauma should always be assumed to have a spinal cord injury even without a diagnostic evidence until proven otherwise. The injury regarded as the least significant in the appearance which might look relatively minor can sometimes prove to be the most serious and lethal. For instance, a blunt trauma along the flank area that appears to have a small circumference bruise that was not earlier identified by imaging studies may have already been bleeding internally in the kidneys.

Another common example is Tension pneumothorax that insidiously expands in size that eventually compresses the lungs and heart causing asphyxiation while the rest of the members of the health care team is engrossed in treating visible wounds and lacerations. While an obvious amputated extremity may appear to be very life-threatening, the body’s natural response to control bleeding is to naturally constrict major blood vessels and with proper management, it can be quickly controlled. However gruesome and devastating an amputated extremity may appear, the same patient might also have other much serious injuries he/she could die off such as internal bleeding which is sometimes difficult to see.

Management

The goal of treatment of multiple trauma is determining the true extent of injuries and establishing the main priorities of treatment. Injuries that greatly interferes with vital physiologic functions such as airway, breathing and circulation is an immediate threat to life and is considered the topmost priority for immediate treatment. Essential life-saving processes are performed simultaneously by the emergency team and as soon as the victim is resuscitated clothes are quickly removed by bandage scissors and a rapid assessment is performed.

The transfer from field management (emergency paramedics) must be orderly and proper endorsement must be given to the receiving party with attention given to the verbal report of the first rescuers at the scene. Upon transfer to the emergency department, emergency protocols are followed and transfer to other specialized units such as the intensive care/trauma unit or operating room usually follows.

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