Trauma is the fifth leading cause of death for all ages combined in the United States as well as the leading cause of death for those ages 1 to 44 years, according to MedicineNet.com. Although not all trauma results in death, trauma still places a tremendous burden on the patient and his family.
Trauma refers to a serious or critical bodily injury, wound or shock. The patient's major concern is the complication of Multiple Organ Dysfunction Syndrome, or MODS. MODS is described as a progressive dysfunction of one or more organ systems that results from an exaggerated and prolonged inflammatory response to severe illness and/or injury, according to "Orthopedic Nursing."
MODS continues to be a major cause of mortality and morbidity after trauma. In addition to MODS, Traumatic Brain Injury, called TBI, occurs commonly in trauma patients. It is associated with poor outcomes and has a mortality rate of approximately 30 percent. Some patients with TBI never awake from a vegetative state, according to "National Center for Health Statistics."
Consequences
In response to serious injury, the body will attempt to compensate and maintain adequate oxygen delivery and blood flow to the heart, lungs and brain. This is accomplished by providing oxygen and replacing any blood loss with fluids and/or blood.
Patients may need breathing support by mechanical ventilation to provide adequate oxygen to the tissues. Trauma patients are at a high risk for developing a severe infection. The infection can be caused from the nature of the injuries, the environment in which the injury occurred or complications after hospitalization.
Outcomes
The goal of therapy for trauma patients with MODS is to support failing organ systems, restore volume replacement, control infections and meet oxygen needs, reports "Orthopedic Nursing." The use of appropriate antibiotics, medications for blood pressure stabilization and mechanical ventilation for oxygen support are treatments that will help improve patient outcomes.
When the body is no longer able to compensate, it will move to a stage of irreversible shock and death is inevitable. Patients who survive severe trauma will often have a long process of rehabilitation following discharge from the hospital.
References
- MedicineNet.com: Definition of Trauma
- "National Center for Health Statistics"; Health, United States, 2005 With Chartbook on Trends in the Health of Americans; Hyattsville, Md.; 2005
- "Deaths: Leading Causes for 2002"; National VItal Statistics Reports, 53(17) 1-10; Anderson & Smith; 2005
- "Orthopedic Nursing"; Multiple Organ Dysfunction Syndrome After Multiple Trauma; Walsh; 2005
- "American Journal of Critical Care"; Advances in the Understanding of Clinical Manifestations and Therapy for Severe Sepsis: An Update for Critical Care Nurses: Ely, Kleinpell, & Goyette; 2003
