In medicine, traumatology (from Greek trauma, meaning injury or wound) is the study of wounds and injuries caused by accidents or violence to a person, and the surgical therapy and repair of the damage. Traumatology is a branch of medicine. It is often considered a subset of surgery and in countries without the specialty of trauma surgery it is most often a sub-specialty to orthopedic surgery. Traumatology may also be known as accident surgery.
Branches of traumatology include medical traumatology and psychological traumatology. Medical traumatology can be defined as the study of specializing in the treatment of wounds and injuries caused by violence or general accidents. This type of traumatology focuses on the surgical procedures and future physical therapy a patient needs to repair the damage and recover properly. Psychological traumatology is a type of damage to one's mind due to a distressing event. This type of trauma can also be the result of overwhelming amounts of stress in one's life. Psychological trauma usually involves some type of physical trauma that poses as a threat to one's sense of security and survival. Psychological trauma often leaves people feeling overwhelmed, anxious, and threatened. [1] Trauma can also be classified as:
Secondary or vicarious trauma, is another form of trauma in which a person develops trauma symptoms from close contact with someone who has experienced a traumatic event. [2]
When it comes to types of trauma, medical and psychological traumatology go hand in hand. Types of trauma include car accidents, gunshot wounds, concussions, PTSD from incidents, etc. Medical traumas are repaired with surgeries; however, they can still cause psychological trauma and other stress factors. For example, a teenager in a car accident who broke his wrist and needed extensive surgery to save his arm may experience anxiety when driving in a car post-accident. PTSD can be diagnosed after a person experiences one or more intense and traumatic events and react with fear with complaints from three categorical symptoms lasting one month or longer. These categories are: re-experiencing the traumatic event, avoiding anything associated with the trauma, and increased symptoms of increased psychological arousal. [3] : 555
Airway management, monitoring, and management of injuries are all key guidelines when it comes to medical trauma care. Airway management is a key component of emergency on-scene care. Using a systematic approach, first responders must assess that a patient's airway is not blocked in order to ensure the patient gets enough circulation and remain as calm as they can. [4] : 19 Monitoring patients and making sure their body does not go into shock is another essential guideline when it comes to medical trauma care. Nurses are required to watch over patients and check blood pressure, heart rate, etc. to make sure that patients are doing well and are not crashing. When it comes to managing injuries, head and neck injuries require the most care post surgery. Head injuries are one of the major causes of trauma related death and disabilities worldwide. It is important for patients of head trauma to get CT scans post surgery to insure that there are no problems. [4] : 28–30
There is a range of approaches to assist victims to overcome the anxiety and stress that follows psychological trauma. Affected persons can also follow self-care such as exercise and socializing with familiar and safe associates and family members. Trauma disturbs the body's natural equilibrium by putting it in a state of fear and hyper-arousal. [1] Exercising for thirty minutes a day facilitated the nervous system to "unfreeze" from a traumatic state. Being surrounded by a good support system is a powerful factor in treating psychological trauma. Participating in social activities, volunteering, and making new friends are all ways to help forget about or cope with traumatic events. Coming to terms with childhood trauma is especially challenging.[ citation needed ]
Factors in the assessment of wounds are:[ citation needed ]
Forensic physicians, as well as pathologists may also be required to examine (traumatic) wounds on people.
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
An injury is any physiological damage to living tissue caused by immediate physical stress. Injuries to humans can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or overexertion. Injuries can occur in any part of the body, and different symptoms are associated with different injuries.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, such as experiencing violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se.
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is controversial within the psychological community. It was devised by Francine Shapiro in 1987 and originally designed to alleviate the distress associated with traumatic memories such as post-traumatic stress disorder (PTSD).
Acute stress disorder is a psychological response to a terrifying, traumatic or surprising experience. It may bring about delayed stress reactions if not correctly addressed. Acute stress may present in reactions which include but are not limited to: intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. Reactions may be exhibited for days or weeks after the traumatic event.
Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Blunt trauma, also known as blunt force trauma or non-penetrating trauma, describes a physical trauma due to a forceful impact without penetration of the body's surface. Blunt trauma stands in contrast with penetrating trauma, which occurs when an object pierces the skin, enters body tissue, and creates an open wound. Blunt trauma occurs due to direct physical trauma or impactful force to a body part. Such incidents often occur with road traffic collisions, assaults, sports-related injuries, and are notably common among the elderly who experience falls.
Compassion fatigue is an evolving concept in the field of traumatology. The term has been used interchangeably with secondary traumatic stress (STS), which is sometimes simply described as the negative cost of caring. Secondary traumatic stress is the term commonly employed in academic literature, although recent assessments have identified certain distinctions between compassion fatigue and secondary traumatic stress (STS).
Critical incident stress management (CISM) was a controversial, non-empirical, adaptive, short-term psychological helping-process that focused solely on an immediate and identifiable problem. It included pre-incident preparedness to acute crisis management through post-crisis follow-up. Its purpose was to enable people to return to their daily routine more quickly and with less likelihood of experiencing post-traumatic stress disorder (PTSD). However, after researchers showed that debriefing techniques did not decrease rates of PTSD, CISM is now seldom used and has largely been replaced with immediate psychological care techniques that do not use debriefing such as those endorsed by the CDC, Red Cross, WHO, American Psychological Association and National Center for Post Traumatic Stress Disorder (NC-PTSD). Responsible practitioners who still use CISM must eliminate debriefing steps in order to remain compliant with best practices and clinical guidelines.
Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.
Stress-related disorders constitute a category of mental disorders. They are maladaptive, biological and psychological responses to short- or long-term exposures to physical or emotional stressors. The National Institute of Environmental Health Sciences categorizes Obsessive-Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder (PTSD) as stress-related disorders. However, the World Health Organization's ICD-11 excludes OCD but categories PTSD, Complex Post-Traumatic Stress Disorder (CPTSD), adjustment disorder as stress-related disorders.
Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.
Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw, as well as trauma such as eye injuries. Symptoms are specific to the type of injury; for example, fractures may involve pain, swelling, loss of function, or changes in the shape of facial structures.
PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.
A moral injury is an injury to an individual's moral conscience and values resulting from an act of perceived moral transgression on the part of themselves or others. It produces profound feelings of guilt or shame, moral disorientation, and societal alienation. In some cases it may cause a sense of betrayal and anger toward colleagues, commanders, the organization, politics, or society at large.
Secondary trauma can be incurred when an individual is exposed to people who have been traumatized themselves, disturbing descriptions of traumatic events by a survivor, or others inflicting cruelty on one another. Symptoms of secondary trauma are similar to those of PTSD. Secondary trauma has been researched in first responders, nurses and physicians, mental health care workers, and children of traumatized parents.
Psychotraumatology is the study of psychological trauma. Specifically, this discipline is involved with researching, preventing, and treating traumatic situations and people's reactions to them. It particularly focuses on the treatment of post-traumatic stress disorder (PTSD) and acute stress disorder (ASD), but can be used to treat any adverse reactions a person may have after experiencing a traumatic event. Since 2021, Certified Trauma Professionals who have achieved a major level of training and clinical expertise can use the abbreviation PsyT after their names as a standard of recognition in the trauma field.
Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.
Disaster psychiatry is a field of psychiatry which focuses on responding to natural disasters, climate change, school shootings, large accidents, public health emergencies, and their associated community-wide disruptions and mental health implications. All disasters, regardless of exact type, are characterized by disruption: disruption of family and community support structures, threats to personal safety, and an overwhelming of available support resources. Disaster psychiatry is a crucial component of disaster preparedness, aiming to mitigate both immediate and prolonged psychiatric challenges. Its primary objective is to diminish acute symptoms and long-term psychiatric morbidity by minimizing exposure to stressors, offering education to normalize responses to trauma, and identifying individuals vulnerable to future psychiatric illness.
Being exposed to traumatic events such as war, violence, disasters, loss, injury or illness can cause trauma. Additionally, the most common diagnostic instruments such as the ICD-11 and the DSM-5 expand on this definition of trauma to include perceived threat to death, injury, or sexual violence to self or a loved one. Even after the situation has passed, the experience can bring up a sense of vulnerability, hopelessness, anger and fear.
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