Major Trauma March 2018 | by EMauthor Trauma is a major cause of morbidity and mortality worldwide. It is the leading cause of death in those aged 1–44 years of age. Basildon Hospital as a Major Trauma Unit which means that we expect so see trauma patients who do not (immediately) require a Major Trauma Centre via the EoE Trauma Triage Tool. These patients will activate a 'trauma call' usually from the pre-hospital team; or occasionally from the waiting room. The same general principles and priorities for trauma management apply to adults and children. Trimodal death distribution First peak—occurs within seconds or minutes of the injury. Deaths are usually due to apnoea due to severe brain injury or high spinal cord injury, or rupture of heart, aorta, or other large vessels. The injuries sustained in this phase are rarely treatable. Only accident prevention can significantly reduce the mortality in this group. Second peak—occurs within minutes to several hours following injury. Deaths in this period are usually due to subdural or extradural haematomas, haemopneumothorax, splenic rupture, liver lacerations, pelvic fractures, and/or other multiple injuries associated with significant blood loss. These injuries may be treatable provided rapid assessment and resuscitation occurs. Third peak—occurs several days to weeks after the initial injury. Deaths are most often due to sepsis and multi-organ failure. Care provided during each of the preceding periods impacts on the outcome during this stage.
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