Trauma is EASY… Or Is It?
Throughout my EMS career, I’ve heard from medics that “trauma is easy” that everyone loves trauma because those calls are so easy. If it is so easy, then why is trauma the leading cause of death in ages under 45 and the fourth leading cause in all age groups (1)? Why do one-third of all traumatic injury patients die (1)? Why are there 43,443 deaths every year due to motor vehicle crashes (1)? These numbers haven't changed much over the year, and why is trauma so easy? Is it because trauma is not so easy, or have we been doing a disservice to our patients?
Trauma is treated routinely, "like a walk in the park" on most scenes; we show up, cut off clothing, start large-bore IVs, dump in liters of cold normal saline, fail to cover them, and reduce hypothermia, and drive too fast to the ER. Trauma is not easy, and we should be treating trauma patients like we do our sick medical patients.
Until recently, trauma patients were easy because we wanted to believe that they were easy and allow the surgeons to do all of the work. Providers keep doing the same ol’ thing because it is "easy." After the run, we go back to the base and pat each other on the back. All the while, one-third of our patients die. This isn't satisfactory, and we need to start using evidence-based medicine in our treatment planning.
Review the literature and take away that information and use it to treat trauma patients effectively. A good first place to start is Google Scholar, Medline, Pubmed, UptoDate, or Cochrane and search “Damage Control Resuscitation.” Read the articles, review the supporting research. Let’s stop contributing to the mortality rates and reduce this number by treating based on peer-reviewed evidence. Start making a difference in not just by transporting fast with an IV in place and a liter of cold normal saline, but instead in saving a patient’s life.
1) The American Association for the Surgery of Trauma. "Trauma Facts." http://www.aast.org/trauma-facts
2) Damage Control Resuscitation. https://pdfs.semanticscholar.org/94aa/260fddf0218aaf277d095857514ee2806281.pdf?_ga=2.19994744.1713514406.1578265547-749496824.1578265547