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Various Aspects of Trauma & Critical Care

Trauma is the life changing experience for the patient and the attendees who nurse them back to health. Annually it impacts hundreds of people. Trauma care has improved a lot in the recent times. The crucial thing is the approach for pre hospital care and hospital care and to the training providers. This article deals with various aspects trauma and critical care.

Various Aspects of Trauma & Critical Care

Various Aspects of Trauma & Critical Care

Let us look at the important management facets of trauma and critical care. Being aware of these important aspects, helps people to face any situation of trauma and critical care better.

Triage: This is providing priority to the severely injured patients among others and provides appropriate care for the most needy in the critical care. The most severely injured patient is given preference and immediate medical care is given to that patient.1 This is an important part of trauma and critical care.

Trauma Scoring: Trauma scoring in trauma and critical care describe injury severity and correlate with survival probability. The scoring systems vary, some depend on the physiologic scores and others rely on descriptions of anatomic injury. The scoring system varies widely and depends on the physiologic scores (Glasgow coma scale {GCS}, Revised trauma score).1

  1. Initial Assessment: Considering the severity and emergency involved in trauma and critical care, initial assessment is very crucial. The principles involved in this are:
  2. Preparation and Transport: The communication and transport of the injured person to the hospital for further treatment.
  3. Primary Survey And Resuscitation: It is to identify and treat life threatening injuries based on airway, breathing, circulation, disability and exposure (ABCDE) system.
  4. Secondary Survey: This follows after the correction of the life threatening injury. Detailed examination is to be done to assess the nature and severity of injury, head and face neurology, neck, chest, abdomen, limbs
  5. On-going Revaluation: The revaluation is done based on ABCDE system, which helps in diagnostic and therapeutic plans.
  6. Definitive Care: The exact treatment required for the nature of the injury is given.1

Preparation and Communication

The hospitals receiving trauma and critical care patients need to be well communicated on the emergency arrival of the patients. The condition of the patient namely vitals, mechanism of injury, field interventions, medical history (if any), blood group, and overall status to be communicated to the receiving hospital. The team leader initiates the resuscitation in an organized manner and makes sure that the patient is given adequate care. 1

Primary Survey

The primary survey for trauma and critical care is conducted based on the ABCDE system and the life threatening injuries are treated immediately. The system consists of airway control with stabilizing the cervical spine, breathing, circulation, disability or neurologic status, exposure of the patient while preventing hypothermia.

  • The airway assessment is done by stabilizing the cervical spine in neutral position using a rigid cervical immobilization collar. If the GCS score is less than 8, the artificial airway is necessary to be established.
  • The breathing of the subject is analyzed by visual inspection of the thoracic cage movement, palpation of the thoracic cage movement and auscultation of the air entry. The administration of high flow oxygen is advised until the stability is established.
  • The bleeding sites should be identified and managed by simple pressure dressing but sometimes surgical intervention may be necessary to stop bleeding.
  • The brief assessment of the subject’s neurologic status is to be performed which includes patient’s posture, pupil symmetry, pupillary response to light, and global assessment of patient’s responsiveness.
  • The exposure of the subject allows locating all injury sites. The initial imaging is restricted only to AP chest radiograph or AP pelvic view.1

Secondary Survey

The secondary survey is done post the completion of the primary survey and the correction is issued for the immediate life threatening condition in trauma and critical care management. The detailed examination of the patient, including evaluation of head, face, neck, chest, abdomen and limbs is done. This is an important part of trauma and critical care management. The re-evaluation is done with ABCDE system and an ongoing diagnostic and therapeutic plan to be revised accordingly.1


The log roll is another important part of trauma and critical care assessment. It includes slow controlled turning of the patient to each side to assess the dependent part of the supine trauma patient. Care must be taken to avoid any further injuries. This helps in removing the immobilization board on which the patient is brought in. This is done by 4 member team – one stabilizing the head, the second & third turn the patient and fourth one to examine the nature of the injury.1

The trauma and critical care management administered in hospital the first few hours of trauma is very essential in the diagnosis and prognosis of the life-threatening injury of the subject. Efficient trauma and critical care team and facility can help in successful recovery of the patient.



Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 2, 2021

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