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- Injury, as opposed to an illness or a disease
- In the usual context, trauma implies a serious or life-threatening Injury, requiring prompt emergency treatment.
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- Usually at least one of the 4 vital signs will be abnormal: blood pressure, pulse, breathing rate, temperature.
- Severe pain, weakness, pallor, some amount of blood loss or Dehydration
- Decreased level of consciousness
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- Penetrating wounds, any type of interaction with a blunt or sharp object
- Burns
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- Often the patient is unable to provide a history, and diagnosis depends on physical examination and X-rays, to determine the type of trauma.
- In case of very serious trauma,
rapid assessment of 5 body areas is one systematic way of
making sure that hidden trauma is not missed, while the
patient's or medical staff's attention is drawn to the most
obvious trauma (in a patient with multiple injuries). The
patient may not be alert enough to provide information. The
5 areas checked are:
- Brain and spinal cord: test pupil responses, level of alertness, ability to move the 4 extremities unaided
- Chest: Assess breath sounds, heart sounds, oxygen content of the blood, chest X-ray, electrocardiogram
- Abdomen: Look for distended abdomen; assess bowel sounds; abdominal X-ray; perform blood tests for liver damage, pancreas damage; pass a plastic tube through the nose or mouth into the stomach if necessary to see if blood is present in suctioned stomach juice. A rectal exam is done to check for blood.
- Kidneys, urinary tract, and reproductive organs: These are not actually in the abdomen -- they are behind the abdomen or below it in the pelvis. A urine sample is obtained and the reproductive organs are examined manually.
- Bones and joints: Look for point tenderness or swelling/bleeding over one particular spot, or crepitus (a crinkling sound or a feeling like the popping of bubble-wrap, occurring over a broken bone)
- Above are listed examples of how these
5 areas are checked.
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- Dangerous occupations
- Falls, auto accidents, fires, natural disasters
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- Clear the airway
- Establish breathing, give oxygen as needed
- Support the circulation of the blood
- Basic life support or advanced life support
- Pain relief
- Repair any damage; this might require the operating room.
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- Need for a respirator to breathe for the patient, and/or medication to support the blood pressure and treat shock (from loss of blood or loss of body water)
- Organ damage may have occurred, either temporary or permanent.
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- Call 911 or local source of emergency aid for any Injury that might be serious.
- Administer cardiopulmonary resuscitation (CPR) to support breathing and the circulation of the blood.
- If you cannot reach your own physician immediately, sometimes urgent advice is available by telephoning an emergency room.
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