Trauma may occur as a result of motor vehicle crash, fights, fall, gunshot, sports, animal bites etc. and is associated with head, musculoskeletal, lacerations, visceral and neurovascular injuries. The aim of managing trauma is to prevent life threatening complications that may lead to increased morbidity and mortality.

There is a systematic trauma protocol in place, Glascow coma score (level of consciousness), trauma score, ABCDE protocol, emphasizing on the primary survey, resuscitation and finally secondary survey.

For Airway

Assess

• If airway is patent?
• Any secretions?
• For tongue fall?
• Any mouth/nose bleeding?
• If patient drowned?
• If patient vomited?
• If patient aspirated?

Intervention

• Place an oral airway.
• Raise the chin of mandible
• Suctioning if required
• Endotracheal intubation (ETT)

For B (breathing)

Assess

• and record Respiratory rate (normal 10-20/min adults; 30– 60/min children)
• Chest asymmetry,
• Abnormal movements
• Chest indrawing
• Locate the trachea centrality
• Ensure air entry into both lungs by auscultation

Interventions

• Assist breathing by mouth to mouth, ambu bag or nasal prongs
• If fails do ETT and mechanical ventilation
• Place the chest tube in case of hemothorax, pneumothorax or tension types
• Plaster the open chest wound

For C(circulation)

Assess

• Arterial pulse
• BP
• Heart sounds for signs of shock

Interventions

• Treat shock accordingly
• Set an I.V. line with isotonic fluids

For D (Disability)

Assess

• Level of consciousness using GCS scale

Intervention

• Treat the head injury accordingly

For E (exposure)

Assessment

• Un-dress the patient to observe for signs of soft tissue injuries or fractures
• Blunt injuries to the chest, abdomen or the dorsal spine may indicate the life threatening ailment underneath

Interventions

• Catheterize
• NGT insertion
• Treat accordingly
• Surgery may be indicated based on specialist requirement