Initial management of trauma victims

Trauma constitutes a large proportion of the number of lives lost, especially in the productive age group. Trauma-related deaths have a trimodal distribution: First, at site or on transfer due to severity of trauma injuries. The injury could be so severe that nothing can be done to save the life of that trauma victim. Second phase of deaths is usually due to hypovolaemia and are often treatable and avoidable. Timely and appropriate intervention at this stage can reduce the effects of trauma and prevent morbidity secondary to the injury. The third phase includes those patients who die of complications of trauma such as infection, embolism, sepsis, ARDS and septic shock. A well-managed second phase is likely to reduce the incidence of the third phase. A systematic approach to a victim of trauma is very necessary so that any life-threatening injury is not missed. The approach to trauma must be done in the following steps: Primary survey and resuscitation, secondary survey and definitive care. This article outlines the various steps of the initial management of trauma.