Trauma care 2

Apr 15th, 2015
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INTRODUCTION TOTRAUMA CARE - II(INITIAL TRAUMA CARE)DR. GEORGE MUGENYAMBCHB, M.MED, FCS (ECSA)DEATH DUE TO TRAUMATraumatic injury is the leading cause of deathin <40 years of age worldwide.These injuries are often multisystem in nature.Many deaths may be preventable by:Prompt recognition of injuries. Recognition of physiological significance ofinjuries. Definitive intervention.TRAUMA DEATH DISTRIBUTIONDeaths from trauma follow a trimodal distribution:1. Immediate deaths in the first minutes at the scene dueto:Massive haemorrhageCrush injuries.Massive CNS trauma.Airway obstruction.2. Early deaths during the Golden hour are often due to:The effects of haemorrhage.The effects of hypoxia.3.Late deaths are chiefly due to:Sepsis'GOLDEN HOUR'The Golden Hour is defined as the time periodof one hour in which the lives of a majority ofcritically injured trauma patients can be savedif definitive surgical intervention is provided.During this period all efforts should be made tosave a life before irreversible pathologicalchanges occur thereby reducing or preventingdeath in the 2nd and 3rd phase...'GOLDEN HOUR''Golden Hour' concept was derived from FrenchWorld War-I data in 1918.Time between injury and adequate shock treatmentdetermined mortality/outcome:Time from injury1 hr2 hr3 hr4 hr5 hr6 hr8 hr10 hrMortality10 %11 %12 %33 %36 %41 %75 %75

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