Surgical emergencies: multiply injured patients
Ashok Handa, Kevin Turner, and Adam Jones explain the principles of advanced trauma care
A call to casualty to attend to a multiply injured patient causes anxiety in most doctors and sets their pulse racing. Fortunately, most hospitals now have a trauma team, and as a house officer in surgery you will be called to help your registrar or senior house officer rather than to deal with patients on your own. In general, most accident and emergency departments will have some warning from the ambulance service and will call you to the resuscitation room to prepare for the arrival of the patient(s).
Multiple trauma, mostly from road traffic accidents, is the leading cause of death among people aged up to 40 years. It is the third highest cause of death in all age groups. In the United Kingdom this is equivalent to 14 airline crashes per year and costs around £600000 per patient. In 1988, the Royal College of Surgeons of England adopted the