Putting a Face on Trauma

Are you more likely to be involved in a traumatic event this year? Studies have been done to tell us who is most likely to be brought in our ED doors on a stretcher. Trauma is defined as injury to human tissues and organs resulting from the transfer of energy from the environment. The term "accident" is being taken out of the current vocabulary since most traumatic injuries and deaths are preventable and don't happen by chance. Hence, the now accepted term for vehicle mayhem is "motor vehicle crash" instead of "motor vehicle accident".


Annually, approximately 164,112 deaths are the result of trauma. Those that survive enter the healthcare system with often long term needs and disabilities with loss of limb, deformity, and a decreased ability to earn a living. Adults between the ages of 35 and 44 are more like to die from being involved in some sort of traumatic event. The leading cause of death for every age group from the ages of 5 to 24 years is a motor vehicle crash (MVC). As far as gender goes, a male is 2.3 times more likely to be involved in injury-producing events than a female. Race also plays a part. A leading cause of death for Caucasians is MVC's. African Americans are most highly affected by intentional trauma between the ages of 10 and 24. Intentional traumas are usually gunshots, stabbings and other forms of assault. Hispanics have the highest rate of fatalities in work related injures, in part because of the agricultural and industrial type labor jobs they hold.


Not surprisingly, alcohol plays a role in almost all types of traumatic injury. The use of alcohol influences judgment, coordination, reflexes, balance and cognitive functions.  With MVC deaths, studies have shown that 25% of drivers aged 15 to 20 years of age had a blood alcohol concentration of 0.08 g/dl or higher. Alcohol is also involved in 25-50% of adolescent and adult fatalities associated with water recreation.


Homicide is the leading cause of death among people aged 10 to 24 years. The increased availability of firearms contributes to the number of deaths from gunshots. Firearms are involved in approximately 70% of homicides, 60% of suicides, 40% of robberies, and 20% of aggravated assaults. Another intentional trauma is child mistreatment. It is estimated that between 1 and 3 million children per year are victims of intentional trauma.


Injury prevention is key in avoiding trauma and committees and researches work daily to enhance injury surveillance systems, develop firearm policies, and fund trauma care system development. Education of the public as well as our health-care providers is crucial to successfully intervene when trauma occurs.


Source: Trauma Nursing Core Course (TNCC) Provider Manual, Sixth Edition, Copyright 2007 by the Emergency Nurses Association.