Radiology in the trauma setting

Trauma is defined as ‘wounding due to physical injury’, resulting from a wide variety of causes. Major trauma is defined as ‘trauma that has the potential to cause death or severe disability’. Trauma is a leading cause of mortality and morbidity in patients under 45 years of age. The primary goal of management is to reduce death and disability. This is achieved by timely diagnosis and prompt treatment of life-threatening injuries by an experienced multidisciplinary team.

The American College of Surgeons’ Advanced Trauma and Life Support (ATLS) guidelines, developed in 1976 following an orthopaedic surgeon’s experience of poor trauma care for his family after a plane crash, sets out a safe, reliable system for the immediate management of trauma patients. ATLS revolutionised trauma care by setting out a reproducible pathway to minimise mortality and morbidity. The initial primary survey detects potentially life-threatening injuries (A – airway, B – breathing, C – circulation, D – disability, E – environment/exposure). The secondary head-to-toe survey detects further non life-threatening injuries. Although ATLS provides a trauma management pathway for any medical professional, anywhere in the world, trauma cases may be relatively rare in individual district hospitals and so the trauma protocol may only be practised occasionally. Studies have found improved outcomes for trauma patients when treated by experienced trauma teams that see large numbers of patients per year.

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