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Being involved in a trauma event means having an injury that requires prompt medical attention, which includes medical examination, testing, and treatment. Trauma can be caused by many types of injuries, whether intentional or unintentional, and may include an emotionally distressing experience or physical injury. Firearm injuries, motor vehicle accidents, and falls are among the most common types of trauma. Young children are more likely to be affected by drowning, while elderly patients are more likely to have ground-level falls (falls while sitting or standing). Trauma can be a frightening and overwhelming experience and can range from minor injuries to life-threatening conditions.

Major hospitals and university hospitals are more likely to have trauma teams. For example, the nearest trauma center to the Rockaways is Jamaica Hospital. Trauma teams are expensive to maintain and must have on-site dedicated teams made up of specialized physicians, surgeons, nurses, and other healthcare professionals. EMS personnel and paramedics may activate a trauma team from the field or hospital emergency staff may do so upon arrival at the facility. Trauma team activation causes the team members to assemble at the trauma bay of the emergency department in anticipation of providing immediate care to the injured person(s) upon arrival at the hospital. Injured patients are typically transported by ambulance or helicopter to the nearest appropriate trauma center.

In the early moments after a traumatic injury, before a patient reaches the hospital, bystanders are often the first responders. The best way to initially help is to call 911. If there is significant bleeding, direct pressure can be applied to the area until help arrives. If an extremity is bleeding, a tourniquet may be employed.

Commercial tourniquets and training on their use are available through Stop the Bleed courses approved by the American College of Surgeons ( ). Bystanders who are trained in CPR or advanced life support can assist the patient until EMS personnel arrive. EMS personnel evaluate the patient’s blood pressure, pulse, respiratory rate, and severity of injuries, and address any life-threatening injuries, such as the inability to breathe or bleeding, at the scene before transport. Sometimes an oxygen mask or breathing tube may be required. A pelvic binder may be placed if a broken pelvis is suspected. Likewise, a cervical collar and a long backboard is often used to stabilize potential spine injuries. Often, EMS personnel may place an intravenous (IV) line for fluid support before or during transport. The patient is strapped to a rigid plastic backboard for transport to the hospital where the trauma team takes over. Heart, oxygen, and blood pressure monitors are used by EMS during transport.

At the hospital, it is imperative to learn as much about the patient’s medical history as possible. Often, the patient may be unconscious, which is why anyone who has any medical condition(s) and/or takes any regular medication(s) needs to have that information with them at all times. Wearing a medical alert bracelet or tag is also helpful, as is carrying information on family, caregivers, or both.

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 By Peter Galvin, MD

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