C|R|I|T|I|C|A|R|E rauma or injury known to cause thousands of deaths every year around the world has seen an upward trend; thanks to our urbanised lifestyle and quest for commodities leading to unplanned industrialisation. It is ironic that the irresistible temptation to make our lives easy and hassle free is also resulting in accidental deaths, crime and violence around us but the irony deepens when you consider the facts of trauma fatality. In India, a total 3,90,884 accidental deaths were reported during the year 2011. During the same time, a total of 6,94,390 cases of ‘unnatural accidents’ caused 3,67,194 deaths and rendered 5,06,348 people injured says the latest National Crime Records Bureau. According to a WHO publication by Dr G Gururaj, Professor and Head, Department of Epidemiology, NIMHANS, Bangalore, “Every year in India, nearly a million deaths occur due to road traffic injuries, falls, burns, poisoning, drowning, suicide, workplace or occupational injury, natural disasters, violence, etc.”
T
Trauma - a major epidemic
S|P|E|C|I|A|L injured to their optimum levels of functioning after an injury.
Trauma facts in India 1) India loses approx 2-2.5 per cent of its GDP to only road traffic injuries 2) All trauma is not road traffic injuries 3) 22.8 per cent of all trauma is transport related injuries 4) Majority 77.2 per cent is other trauma like: i) Falls (paediatric age group) ii) Agricultural related trauma iii) Fire Arms, Intentional self harm iv) Assault, Fall of objects v) Burns, Drowning vi) Natural Disasters vii) Terrorist Attacks viii)Possibility of “NBC” events
Ref: traumaindia.org Traumatic injuries have been described as the largest epidemic of the 20th century. In view of the number of victims and the associated costs, they have been also been called the most severe and longest war of the contemporary world. According to WHO, injury will be the third leading cause of death in India by the year 2020. Some experts opine that trauma is the third leading killer in India, next only to heart disease and cancer. In the developed world, it is the leading killer of young persons in their productive years, from
1-44 years of age. According to a report by Dr MK Joshipura, Orthopaedic and Trauma surgeon, Ahmedabad, “Every 1.9 minutes a trauma-related death occurs in India.” Trauma not only results in tremendous human tragedy where invaluable human life is lost but also causes loss of limbs and permanent disability. WHO directive explains that the goals of good trauma care are to prevent deaths among those surviving the initial impact, reduce complications and disabilities among those hospitalised and return the
Trauma care - a joint effort Co-ordination and planning are the pillars on which trauma care stands. “The key components of a trauma care system include efficient pre-hospital care, appropriate hospital care (encompasses efficient acute care facilities, functioning trauma care centres, planned and coordinated responses for injured patients and collaboration within and outside healthcare systems) and adequate disability reduction activities. Hence, a trauma care system includes coordinated activities at all levels and is performed by individual members of the team to cover pre-hospital and emergency care, acute hospital care and rehabilitation services,” points out Dr Gururaj. “As soon as a patient comes to us, we treat the patient as per the advanced trauma life support (ATLS) protocols. Firstly, a primary survey is done. During this primary survey, we check whether the patient is stable or has a life threatening disorder. If there is any life
The tsunami that hit the Indian coasts in 2004 caused heavy losses to life and property
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AUGUST 2012