A trauma center, or trauma centre, is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. A trauma center may also refer to an emergency department without the presence of specialized services to care for victims of major trauma.
The year 2003 was an exciting one for new scientific discoveries and technological breakthroughs progress in many scientific fields. Some of the highlights of 2003, which will be further discussed below, include: the anthropologic discovery of 350,000-year-old footprints attesting to the presence of upright-walking humans; SpaceShipOne flight 11P making its first supersonic flight; the observation of a previously unknown element, moscovium was made; and the world's first digital camera with an organic light-emitting diode (OLED) display is released by Kodak.
Internal bleeding is a loss of blood from a blood vessel that collects inside the body, and is not usually visible from the outside. It can be a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding. Severe internal bleeding into the chest, abdomen, pelvis, or thighs can cause hemorrhagic shock or death if proper medical treatment is not received quickly. Internal bleeding is a medical emergency and should be treated immediately by medical professionals.
Major trauma is any injury that has the potential to cause prolonged disability or death. There are many causes of major trauma, blunt and penetrating, including falls, motor vehicle collisions, stabbing wounds, and gunshot wounds. Depending on the severity of injury, quickness of management, and transportation to an appropriate medical facility may be necessary to prevent loss of life or limb. The initial assessment is critical, and involves a physical evaluation and also may include the use of imaging tools to determine the types of injuries accurately and to formulate a course of treatment.
Neurogenic shock is a distributive type of shock resulting in hypotension, often with bradycardia, caused by disruption of autonomic nervous system pathways. It can occur after damage to the central nervous system, such as spinal cord injury and traumatic brain injury. Low blood pressure occurs due to decreased systemic vascular resistance resulting from loss of sympathetic tone, which in turn causes blood pooling within the extremities rather than being available to circulate throughout the body. The slowed heart rate results from a vagal response unopposed by a sympathetic nervous system (SNS) response. Such cardiovascular instability is exacerbated by hypoxia, or treatment with endotracheal or endobronchial suction used to prevent pulmonary aspiration.
Coagulopathy is a condition in which the blood's ability to coagulate is impaired. This condition can cause a tendency toward prolonged or excessive bleeding, which may occur spontaneously or following an injury or medical and dental procedures.
A gunshot wound (GSW) is a penetrating injury caused by a projectile from a gun. Damages may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part of the body, and in severe cases, death. Damage depends on the part of the body hit, the path the bullet follows through the body, and the type and speed of the bullet. Long-term complications can include bowel obstruction, failure to thrive, neurogenic bladder and paralysis, recurrent cardiorespiratory distress and pneumothorax, hypoxic brain injury leading to early dementia, amputations, chronic pain and pain with light touch (hyperalgesia), deep venous thrombosis with pulmonary embolus, limb swelling and debility, and lead poisoning.
Penetrating trauma is an open wound injury that occurs when an object pierces the skin and enters a tissue of the body, creating a deep but relatively narrow entry wound. In contrast, a blunt or non-penetrating trauma may have some deep damage, but the overlying skin is not necessarily broken and the wound is still closed to the outside environment. The penetrating object may remain in the tissues, come back out the path it entered, or pass through the full thickness of the tissues and exit from another area.
Sean Patrick Francis Hughes is emeritus professor of orthopaedic surgery at Imperial College London where he was previously professor of orthopaedic surgery and head of the department of surgery, anaesthetics and intensive care. Earlier in his career he had been professor of orthopaedic surgery at the University of Edinburgh.
Peter Meong Rhee is an American surgeon, medical professor, and military veteran. During his 24 years in the United States Navy, Rhee served as a battlefield casualty physician in Afghanistan and Iraq.
Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for initially resuscitating and stabilizing and later evaluating and managing the patient. The attending trauma surgeon also leads the trauma team, which typically includes nurses and support staff, as well as resident physicians in teaching hospitals.
Damage control surgery (DCS) is surgical intervention to keep the patient alive rather than correct the anatomy. It addresses the "lethal triad" for critically ill patients with severe hemorrhage affecting homeostasis leading to metabolic acidosis, hypothermia, and increased coagulopathy.
A resuscitative thoracotomy (sometimes referred to as an emergency department thoracotomy (EDT), trauma thoracotomy or, colloquially, as "cracking the chest") is a thoracotomy performed to resuscitate a major trauma patient who has sustained severe thoracic or abdominal trauma and who has entered cardiac arrest because of this. The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation. The procedure is rarely performed and is a procedure of last resort.
Sir Keith Malcolm Willett is Professor of Orthopaedic Trauma Surgery at the University of Oxford.
Joseph V. Sakran is an American trauma surgeon, public health researcher, gun violence prevention advocate and activist. His career in medicine and trauma surgery was sparked after nearly being killed at the age of 17 when he was shot in the throat. He is currently an associate professor of surgery at the Johns Hopkins University, director of Emergency General Surgery at Johns Hopkins Hospital, and vice chair of Clinical Operations. He also serves as the Associate Chief for the Division of Acute Care Surgery.
Shafi Ahmed is a chief surgeon, teacher, futurist, innovator, professor and entrepreneur.
Endovascular and hybrid trauma and bleeding management is a new and rapidly evolving concept within medical healthcare and endovascular resuscitation. It involves early multidisciplinary evaluation and management of hemodynamically unstable patients with traumatic injuries as well as being a bridge to definitive treatment. It has recently been shown that the EVTM concept may also be applied to non-traumatic hemodynamically unstable patients.
Hasan Badre Alam is a trauma surgeon, surgeon-scientist, and a medical professor in the United States. He is the Loyal and Edith Davis Professor of Surgery, the Chairman of Department of Surgery at the Feinberg School of Medicine (FSM)/Northwestern University, and the Surgeon-in-Chief at Northwestern Memorial Hospital (NMH) in Chicago.
Paul Coulthard, BDS, MFGDP(UK), MDS, FDSRCS(Eng), FDSRCS(OS), PhD, FDSRCPS(Glas), FFDTRCS(Ed), FDSRCS(Ed), FCGDent is a British Academic Surgeon and Scientist.
