Trauma and Emergency Surgery

Lesson Objectives

By the end of this topic, learners should be able to:

1. Understand the principles of trauma assessment and emergency surgical care.

2. Identify common traumatic injuries requiring surgery.

3. Recognize complications and post-operative care priorities in trauma patients.

4. Apply trauma and emergency management protocols (ABCDE, damage control surgery).

 Key Glossary Terms

1. Primary Survey (ABCDE)

• Definition: Rapid assessment to identify life-threatening conditions in trauma patients

• Components:

  • A – Airway with cervical spine protection

  • B – Breathing and ventilation

  • C – Circulation with hemorrhage control

  • D – Disability (neurological assessment, GCS)

  • E – Exposure and environmental control

2. Secondary Survey

• Definition: Head-to-toe examination after stabilization of life-threatening injuries

• Includes: Full history (AMPLE: Allergies, Medications, Past history, Last meal, Events leading), detailed physical exam, diagnostic imaging

3. Damage Control Surgery

• Definition: Rapid, abbreviated surgical interventions to control hemorrhage and contamination, delaying definitive repair until patient stabilization

• Indications: Polytrauma with shock, coagulopathy, hypothermia

4. Hemorrhage Control

• Methods: Direct pressure, tourniquets, hemostatic agents, surgical ligation, embolization

• Importance: Uncontrolled bleeding is a leading cause of preventable trauma death

5. Traumatic Injuries

• Common Types Requiring Surgery:

  • Abdominal trauma (solid organ laceration, bowel perforation)

  • Thoracic trauma (hemothorax, tension pneumothorax)

  • Orthopedic trauma (open fractures, compartment syndrome)

  • Vascular injuries

6. Shock

• Definition: Life-threatening circulatory failure resulting in inadequate tissue perfusion

• Types in Trauma: Hypovolemic (most common), neurogenic, cardiogenic, septic

• Management: IV fluids, blood transfusion, treat underlying cause

7. Post-Operative Considerations

• Monitoring vitals, bleeding, organ function

• Pain management and sedation if required

• Wound care and infection prevention

• Early mobilization and physiotherapy for orthopedic injuries

8. Nursing & Medical Student Focus

• Nursing: Rapid assessment, hemorrhage control, airway management, fluid resuscitation, post-op monitoring, psychological support

• Medical Students: Apply trauma protocols (ATLS principles), recognize surgical indications, perform emergency procedures, monitor complications

9. Trauma Surgery Mnemonics

• “ABCDE” – Primary survey steps (Airway, Breathing, Circulation, Disability, Exposure)

• “AMPLE” – Secondary survey history (Allergies, Medications, Past history, Last meal, Events)

• “MARCH” – Hemorrhage control in pre-hospital trauma:

  • Massive hemorrhage

  • Airway

  • Respiration

  • Circulation

  • Hypothermia

 Tables

Table 1: Common Trauma Surgeries

Table 2: Post-Operative Nursing Care in Trauma Surgery