Traumatic Injury

What is a traumatic injury?

A traumatic injury is any physical injury that could cause serious medical conditions or be life-threatening. A traumatic injury could be an injury that causes you to lose a lot of blood or causes a serious head injury.

Traumatic injuries are common in the U.S. The Centers for Disease Control and Prevention (CDC) estimates injuries account for 40 million emergency room visits every year. You can experience a traumatic injury at home, work or simply while driving or walking.

Falls and motor vehicle crashes are the most common causes of traumatic injuries. But you can have a traumatic injury from an assault, like being shot, stabbed or hit hard with an object. Traumatic injuries are medical emergencies. If you think you or someone else may have a serious injury, call 911 or emergency services right away.

Traumatic injuries also are life-changing events. The impact of a traumatic injury can ripple through your life and the lives of the people who care for you. It takes time to recover from a traumatic injury. Your progress may be slow, so try to be patient with the process, with yourself and those around you.

Types of traumatic injuries

Healthcare providers classify traumatic injuries by how an injury happens and the impact it has on your body. There are three types of traumatic injuries:

• Blunt force traumatic injury: Blunt force trauma is the most common type of traumatic injury. Blunt force is when something hits you so hard that you have injuries like broken bones, internal bleeding or external bleeding from very deep cuts or wounds or head injuries like a severe concussion.
• Deceleration traumatic injury: This is a traumatic injury that happens when you’re in motion and you suddenly stop. For example, if you’re driving at the speed limit and hit something, your head may hit the steering wheel. When that happens, your brain may bounce from back to front or side to side, causing brain damage.
• Penetrating traumatic injury: Penetrating traumatic injuries happen when something breaks through your skin so you have a wound. You may have penetrating trauma from assaults like a shooting or stabbing. But you may also have a penetrating traumatic injury if you fall on a very sharp object or are hit by shrapnel from an explosion.

What is a major traumatic injury?

In general, a major traumatic injury is when you have several life-threatening injuries in several areas of your body. Healthcare providers use a standard review process to decide if someone has major traumatic injuries. That process is the Injury Severity Score (ISS).

The ISS system helps providers make consistent treatment decisions instead of handling traumatic injuries on a case-by-case basis. For example, if you have a traumatic injury, a provider will use the score to decide if you should be admitted to the hospital or transferred to a medical trauma center. Providers assess:

• The number of injuries: Providers will note the number of injuries in each of the following areas of your body: head and neck, face, throat, belly and pelvis, arms and legs, and skin.
• The severity: Injuries may be mild, moderate, serious, severe, critical and maximal or untreatable. The more serious the injury, the higher the point assigned to that injury. For example, a mild injury receives a single point. A six-point score means an injury is so severe there’s no treatment that can prevent death.

To set an ISS, providers identify the three areas of your body with the most severe injuries. They use the six-point severity scale to get scores for the most serious injuries in each of the three areas. Then, they find the square of the three scores and add those figures to produce the ISS. The scores range from 3 to 75. An ISS score of 15 or above is a major traumatic injury.

What medical conditions do traumatic injuries cause?

Traumatic injuries may cause many different medical conditions, including:

• Broken bones, including spinal fractures.
• Collapsed lung.
• Compartment syndrome.
• Deep cuts.
• Electric shock.
• Flail chest.
• Head injuries, like an epidural hematoma, skull fracture, subarachnoid hemorrhage, subdural hematoma or traumatic brain injury.
• Hemorrhage.
• Myocardial contusion.
• Severe concussion.
• Severe hypovolemia (hypovolemic shock).
• Spinal cord injuries.
• Traumatic abdominal injuries, like injuries that affect your duodenum, pancreas or spleen and cause internal bleeding.
• Traumatic amputation.
• Ruptured aorta.

What are the symptoms of a traumatic injury?

Symptoms vary depending on how a traumatic injury affects you. For example, you may have external bleeding if you have deep cuts after being in a motor vehicle crash. If the crash causes a compound fracture, part of a broken bone is sticking out of your skin. If you have broken ribs (flail chest), it hurts when you take a breath and you have trouble breathing.

How are traumatic injuries treated?

Initial treatment involves the following steps, sometimes called the ABCDE of traumatic injury treatment. The steps are:

1. Airway: Providers will check for signs that something is blocking your airway so you can’t breathe.
2. Breathing: They’ll check your breathing to make sure you don’t have a collapsed lung (pneumothorax). They’ll also make sure the endotracheal tube that keeps your airway open is in the correct position.
3. Circulation: They’ll immediately treat any injuries that cause external bleeding and check for internal bleeding symptoms, like symptoms that show you may be going into shock.
4. Disability: They’ll do tests to check for neurological issues or spinal cord injuries.
5. Exposure: They’ll remove all of your clothes to do a thorough check of your body to be sure they don’t miss an injury.

Providers treat the most serious medical conditions first. Often, that means a trauma surgeon will do emergency surgery to treat any life-threatening injuries or conditions.

Your treatment will depend on your specific traumatic injuries. Your trauma surgeon may work with specialists, including vascular surgeons, for injuries involving your blood vessels, orthopaedic surgeons for injuries that affect bones, and neurosurgeons for injuries that affect your brain.

Your treatment will continue throughout your recovery. For example, you may have:

• Physical therapy.
• Occupational therapy.
• Mental health support to help with issues like depression, anxiety and post-traumatic stress disorder (PTSD).

Can I prevent a traumatic injury?

No, but you can reduce your risk of experiencing one. For example, motor vehicle crashes are a leading cause of traumatic injury. You can reduce your risk of being hurt in a crash by always wearing a seatbelt and never driving while you’re under the influence of alcohol or drugs, including prescription drugs that you’re taking as your healthcare provider recommends.