The trauma committee at a level II trauma center is discussing ways to reduce death during the second peak of the trimodal distribution for trauma deaths. The trauma nurse on the committee suggests which intervention to reduce deaths during this time frame?
A) Passing and enforcing helmet laws
B) Transporting victims to a trauma center with qualified staff
C) Enforcing highway safety
D) Recognizing early signs of shock
B) Transporting victims to a trauma center with qualified staff
Explanation: A) The first peak of trauma deaths is those that occur instantly, at the scene of the injury. An example of this would be death from a massive head injury or penetrating wound to the heart or aorta, which would cause immediate exsanguination. The only way to save these patients is through aggressive prevention strategies such as helmet laws and highway and automobile safety.
B) The second peak of trauma deaths occurs in the early minutes and early hours of injury. Most of these deaths occur from major injuries to the head, chest, and abdomen. Deaths during this peak of trauma can be decreased by enforcing a trauma system that accurately identifies these vulnerable patients and quickly transports them to an appropriate trauma center that is staffed with qualified surgeons, nurses, and operating room personnel.
C) The first peak of trauma deaths is those that occur instantly, at the scene of the injury. An example of this would be death from a massive head injury or penetrating wound to the heart or aorta, which would cause immediate exsanguination. The only way to save these patients is through aggressive prevention strategies such as helmet laws and highway and automobile safety.
D) The third peak of trauma deaths occurs when trauma patients die in the hospital, usually in the intensive care unit. These deaths occur when the organ damage that occurred during the initial injury and the resuscitation phase begins to fulminate or when sepsis develops. Multiple organ failure begins to occur, often resulting in shock and death, usually days or weeks after the initial injury. Aggressive resuscitative care, prompt recognition of early signs of shock and organ ischemia, and early treatment of these injuries are paramount in the ongoing treatment of acutely injured patients.
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