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Like other diseases, trauma has well-defined causes. This is not just due to the rising numbers of older people, but because many are now able to lead more-active lifestyles, while living with conditions such as osteoporosis that increase the risk of fractures, or are taking medications that may increase the complications of trauma (for example, bleeding associated with anticoagulants). Over the past 10 years, the major trauma population has become older, and the most common mechanism of major trauma in the UK, away from urban areas, is now a fall from standing or a fall from a height of less than two metres (Kehoe et al, 2015).
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This is not always as obvious as might be expected, as some patients, such as older people, can sustain life-threatening injuries through low-level or minor-impact falls. Timely expert care in a specialist major trauma centre (MTC) is essential to achieve a good recovery.Īmbulance and emergency services use triage algorithms to identify the most seriously injured patients quickly. The term ‘major trauma’ is used to describe serious injury or a combination of injuries that may mean life-saving interventions are needed. Traumatic brain injury and spinal cord injury are specific types of major trauma, often with devastating long-term consequences. Injuries can be severe and complex, often with multiple fractures, nerve and soft tissue damage, and sometimes traumatic limb loss. However, from a public-health perspective traumatic injury is considered a disease, which emphasises its predictable and preventable nature (Esposito and Brasel, 2013). Traditionally, traumatic injuries have been considered a result of accidents. As well as the physical consequences of trauma, people can also experience emotional or psychological difficulties, which may become long-term disabilities (WHO, 2021). Among these, many result from suicide attempts, which globally account for >50% of all violent deaths in men and 71% in women (WHO, 2014). For every trauma death, there are many survivors who sustain life-changing injuries or serious disability (WHO, 2021). In the UK, approximately 16,000 people die from traumatic injury every year (Trauma Audit and Research Network, nd). Trauma is the main cause of death worldwide among children and young people (World Health Organization (WHO), 2021). Click here to see other articles in this series.Scroll down to read the article or download a print-friendly PDF here (if the PDF fails to fully download please try again using a different browser).This article has been double-blind peer reviewed.Nursing Times 118: 11.Īuthors: Susana Lucena-Amaro is matron, adult critical care, Barts Health NHS Trust, and honorary lecturer in major trauma, City, University of London Parjam Zolfaghari is consultant in intensive care medicine and anaesthesia, Barts Health NHS Trust and honorary senior lecturer, Queen Mary University of London. Further articles in the series will look at specific areas of trauma management, from rib fracture and head injury to bleeding and self-harm.Ĭitation: Lucena-Amaro S, Zolfaghari P (2022) Trauma nursing 1: an overview of major trauma and the care pathway. This first article in a series on trauma nursing introduces the main aspects of major trauma, the different elements of the trauma care pathway from pre-hospital care to rehabilitation, and the specialist nursing skills and knowledge needed when caring for trauma patients.