World trauma day 17’October 2017
Trauma means “any injury caused to the body”. The injury may be caused due to many reasons like road accidents, fires, burns, falls and acts of violence. Amongst all the causes, Road Traffic Accident (RTA) is the leading cause of trauma across the world. Apart from causing deaths, trauma will, by 2020, be ranked third for causing disabilities among the Indian population.
World trauma day 17’Oct highlights the increasing rate of accidents and injuries causing death and disability and the need to prevent them. It is of crucial importance to raise people’s awareness on how to handle common soft tissue, oragan, bone and joints injuries, as simple procedures and precautions when handling the injured person at first make dramatic changes in the treatment process. As there are a large number of young people in India, and the possibility of injuries due to work, road accidents or even routine sport activities, making it necessary to raise people’s awareness on how to avoid injuries and how to handle them when required.
There is a urgent need to emphasize the importance of saving and protecting a life during the most critical moments and preparing and applying critical measures to deal with and avoid trauma fatalities. The best approach to traumatic injury is to prevent it before it happens. Help does not reach within the golden hour. If people are careful and observe safety and wear helmets, then the maximum number of deaths can be prevented. It is advocated to have emergency medicine courses for the common people, starting from the school level.
Physical disability resulting from RTAs also hugely impacts the society. Most of these patients are employed at the time of injury and the injury changes their lives forever. In addition to losing the financial productivity of the patient, another person needs to stay back with the patient to take care of him/her. Thus the family loses the financial productivity of two persons in addition to incurring the enormous medical expenses. Sadly in India, this economic burden resulting from RTA is borne out solely by the family of the patient.
What is trauma care? The whole spectrum of trauma care involves, from pre-hospital standard-setting and leadership, to emergency department resuscitation, appropriate transfer to definitive care with coordination of rehabilitation and reintegration of the patient and his/her family back into society. With different “levels” of trauma care facility, the right patient should be taken to the most appropriate facility in the most expedient timeframe. Trauma care is achieved through the Advanced Trauma Life Support short course for doctors, nurses and paramedics; and the teaching of the Definitive Surgical Trauma Care course for trainee and specialist surgeons
Trauma care in India is poorly coordinated. Inadequate emergency and trauma care, lack of trauma audits and deficiencies in acute trauma care account for a higher number of deaths and greater number of disabilities. Lack of first aid, delays in transfer of patients, longer time interval between injury and reaching a definitive hospital, absence of triage, lack of facilities in hospitals are some major problems in trauma care in India.
What is a trauma center? A trauma center is a type of hospital that has resources and equipment needed to help care for severely injured patients. The American College of Surgeons Committee on Trauma classifies trauma centers as Level I to Level IV. A Level I trauma center provides the highest level of trauma care while Level IV trauma centers provide initial trauma care and transfer to a higher level of trauma care if necessary. Trauma systems help to ensure that the millions of people injured each year get the right care, at the right place, at the right time. The right care can help people continue to live to their full potential, despite having experienced a severe injury.
Despite all these advancements, trauma care remains the dearth of the emergency fraternity, with little research funding, directed health expenditure and limited career-pathing for those who are dedicated enough to follow this noble profession. Rehabilitation is often seen as an afterthought, with much less success in returning many people to the state of gainful employment. The Society calls on government on the horizon to prioritise the care of these patients and to ensure facility accreditation, both in the public and private sectors, so we can serve all the injured people at best.
Dr Manoj Pahukar
MS Ortho, DNB Ortho, MNAMS, FKS Belgium, AO trauma Hongkong
Senior Orthopaedic Consultant – Arthroscopy, Complex trauma & Joint replacement,
Wockhardt Hospitals, Nagpur
