Initial assessment of the trauma patient: a nursing approach

Abstract

Traumatic injuries or trauma refers to physical injury that occurs suddenly and is potentially severe in form, requiring immediate medical assistance such as resuscitation or other actions to prevent permanent damage or death. Major trauma is usually caused by external forces such as falls, road accidents, assaults, crush injuries, burns etc. Severe traumatic injury requires admission to a hospital for assessment, treatment and rehabilitation, and the full extent of the injuries calls for thorough diagnostic and therapeutic procedures. Moreover, the patient who experiences physical trauma will more often than not face longterm psychological difficulties due to the shock of the unanticipated injury. According to the World Health Organization, traumatic injury accounts for 9% of global mortality. Only in the USA, traumatic injury is the first cause of death in ages 1-46, with a staggering 47%. The leading cause of traumatic injury are road traffic injuries, with more than 1.25 million people worldwide losing their life each year as a result of traffic crashes. Since the human population increases along with the number of vehicles worldwide, traffic accidents alone slowly develop into a modern pandemic that acquires the epidemiology trend of a disease, burdening the health systems with requirements for short or long-term hospitalizations, emergency department visits and thousands of doctor hours. In Greece, a country with a population of 10.77 million people, the Hellenic Statistical Authority reports that in the period 2000-2015 approximately 250,000 road accidents occurred resulting in 22,500 deaths and 32,500 people with severe injuries and disabilities. 50% of all trauma deaths usually occur within the first hours of injury. They are usually related to brain injury, cardiovascular collapse or hemorrhage and can be prevented if properly treated. It therefore becomes evident that the survival of patients and the prevention of disabilities rely on securing that the right patient receives the most appropriate treatment in the shortest time possible. In the effort to save the patient’s life, a multidisciplinary team of health professionals has to collaborate closely. These professionals must work together to assess and manage the trauma patient. They come from the areas of emergency medicine, nursing, surgery, intensive care and support, and are all coordinated by a team leader. Their aim is to quickly resuscitate and stabilize the trauma patient, determine the nature, extent Abstract