Multiple Trauma

Scope
There are many complications that can arise from multiple trauma injuries. Because one injury or systemic failure can have a substantial impact on the others, communication and coordination among all specialists is crucial to achieving beneficial outcomes.

The major causes of multiple trauma include car accidents, pedestrian/auto accidents, gunshot wounds, crush injuries, and falls.  Simple trauma, such as a single laceration or a simple solitary fracture, can often be definitively managed in general hospital settings; however, when multiple simultaneous injuries occur (for example: multiple fractures, crush injuries, solid organ contusions and lacerations, extensive hemorrhaging, etc.), then the care required becomes much more complex and critical.  Without such expert care, complications such as shock, sepsis, kidney and heart failure may be superimposed on the original injury picture and may cause significantly more morbidity, long-term disability, and even cause death.

Financial Consequences
At an estimated cost of $16 billion annually, the acute phase of trauma care is the second largest source of expenditures for medical care in the US.  Factor in deaths, disability, lost wages and taxes, and acute medical care and the estimate soars to $150 billion each year.  According to the American College of Surgeons, reducing costs and improving outcomes of trauma care depends on the quality of initial assessments and whether there is an organized, systematic approach to care and treatment.

Physical Consequences
Studies have shown that complications associated with traumatic injuries are one of the most influential variables affecting hospital length-of-stay, total cost, and period of rehabilitation. Some of the most prevalent complications include:

• Respiratory failure
• Sepsis (blood infection)
• Pneumonia
• Respiratory distress
• Multiple organ failure
• Blood clots
• Heart failure
• Abscess formation
• Skin breakdown
• Wound infection
• Chronic pain
• Nonunion or malunion of fractures

Treatment Challenges
The care of multiple trauma victims is an intricate process that encompasses a wide range of services and specialists. There are many challenges to treating this complex medical condition that can impede recovery, including:

• Need for trauma specialists. Ideally, all injured persons suffering significant trauma would be initially treated by trauma surgeons.
• Coordination of specialties. Most injured workers are cared for by a team of specialists who are each concerned with a specific body part or system, rather than focusing on the total needs of the individual.  Maintaining coordination among these specialist providers is critical to optimal outcome.
• Communication among specialists. Constant contact among specialists is crucial to ensuring that everyone works toward the same optimal outcome.
• Focusing on the long-term. The long-term outcome is often overlooked, especially in the acute phase of treatment, when the priority is stabilization and survival rather than long-term functioning. Clinicians who, in addition to survival, plan toward the final functional outcome, can reduce costs, improve such outcomes, and speed recovery.

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Disclaimer: This site is for informational purposes only. The content on this site is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your health care provider if you have any questions regarding your medical condition. Please note that interactions on this site between you and a physician or nurse do not constitute or result in the formation of a physician/injured worker and/or nurse/injured worker relationship.