Trauma update 2013

Abstract

All over the world, and not least in South Africa, clinicians continue to face the scourge of traumatic injury. The regularity with which patients require the collaborative effort of all or many of an institution’s resources, simultaneously, makes this disease difficult to manage clinically, as well as socio-economically. Also, understanding of the pathophysiology of trauma has given insight into the heterogeneity of injury and the ensuing physiological response, as well as the response to, and effectiveness of, resuscitative efforts. While the development of a protocol-based intervention with regard to the trauma patient, especially during early care, has resulted in significant improvements in trauma-related mortality, protocols are often deficient within the hospital setting, especially within the realm of the operating room or the intensive care unit. This update aims to focus on the identification and treatment of trauma patients along this spectrum of presentation, present modern management of the major contributors to mortality and morbidity, and highlight common pitfalls of which clinicians should be aware when managing the trauma patient.