saving lives and protecting lives first aid trauma golden hours

1. Asnss’s
S.B.SHIRKOLI HOMOEOPATHIC MEDICAL COLLEGE
SHRI DURADUNDEESHWAR HOMOEOPATHIC HOSPITAL
SANKESHWAR
WORLDTRAUMA DAY
-HEM SHAH & SNEHA MANOLI
(INTERNEE)

2. 0VERVIEW
• TERMINOLOGY
• INTRODUCTION
• TRAUMA
• EPIDEMOLOGY
• HISTORY
• TRAUMA DAY
• HELPLINE
• DO’S AND DON’TS
• CLASSIFICATION OF INJURY
• MECHANISM OF INJURY
• MOST COMMON PARTS OF
INJURIES
• GOLDEN HOURS
• SURVEYS
• ASSESSMENT OF THE INJURED
PATIENT
• FIRST AID KIT
• SHOCKING FACTS

3. TERMINOLOGY
• INJURY - The result of harmful event that arises from the release of
specific forms of energy.
• TRAUMA - Injury of one more systems, that results in excessive
bleeding and may affect the normal body functioning.

4. INTRODUCTION
• World Trauma Day occurs every year on October
17th.
• The day focuses on the importance of saving and
protecting lives during emergencies. It’s also a day
to provide education on how to avoid traumatic
injuries and deaths.
• This day is marked to consider strategies for the
prevention and management of traumatic events
which occur each year in India.
• The World Health Organization recognizes trauma
as a major cause of disability and death globally;
• Traumas kill more people than HIV and cancer put
together. Most of trauma deaths occur in low and
middle income countries which lack robust trauma
care and emergency care specialty.

5. WHAT IS TRAUMA?
• Trauma refers to an injury caused to the body. The reasons for injury could
vary from road accidents, falls, burns, industrial explosions, and fires to
violence against women, elders and children.
• Traumatic injuries from any cause can lead to temporary or permanent
disability. It especially affects the younger working population thereby
lowering the national productivity of any nation.
• Every year, almost 5 million people die from injuries across the world. An
estimate indicates that 1 million people in India die from injuries and 20
million are hospitalized each year.
• The National Crime Records Bureau statistics indicate that 1,37,000 people
died in motor accidents in 2013. Road accidents are the leading cause of
trauma both in India and globally.
• Good road design and maintenance can prevent traumatic road accidents.
It is also necessary to have good trauma care to immediately deal with the
fall outs of accidents. If timely emergency care is available, nearly 2 million
lives can be saved every year in low and middle income nations.

6. • In India, lives are lost and people become disabled permanently due to
inadequate pre-hospital care. Often, road accident victims are left bleeding
on the road as citizens do not want to help and get involved. The first few
minutes being critical are lost as nothing is done to help the victim. Traffic
jams often prevent ambulances from reaching the spot on time. Such
delays impact the crucial first few hours in protecting and saving the victim.
The Law Commission of India observed that 50% of those killed in road
accidents could have been saved with timely help.
• In a landmark judgment in March 2016, the Supreme Court of India passed
an order on the recommendations of a three-member committee to
protect citizens who can help save road accident victims. This will prevent
the police and other authorities from harassing those who report the
accident or help the victim. No citizen can be forced to be a witness if
he/she chooses not to be. This judgment will go a long way because good
Samaritans who can help accident victims will do so without fears.

7. EPIDEMOLOGY
• 3242 persons die each day around the world
• 50 million people are disabled or injured every year.
• India - 1% of motor vehicles in the world but bears the burden of 6%
of global vehicular accidents
• Unfortunately, a majority of trauma survivors are either confined to
bed or wheel chair for the rest of their lives.
• The tragedy of India : 78% of the victims are MEN (Aged:- 22 – 44)
• A vehicular accident reported every 3 min and a death every 6min on
Indian roads.

8. WORLD TRAUMA DAY HISTORY
• World Trauma Day began in New Delhi, India, in
2011. More than 400 people die each day as a result
of road accidents in India. World Trauma Day was
created as a way to decrease this number in their
country and other countries around the world.

9. WORLD TRAUMA DAY
• World Trauma Day marked on 17th October each year commenced in
New Delhi. The Trauma Society of South Africa joined in a year later.
• This day is marked to consider strategies for the prevention and
management of traumatic events which occur every year in both
India and South Africa.
• The World Health Organization recognizes trauma as a major cause of
disability and death globally.
• Traumas kill more people than HIV and cancer put together. Most of
trauma deaths occur in low and middle income countries which lack
robust trauma care and emergency care specialty.

10. HELPLINE
• In most Indian cities and large towns, ambulance services are
available to assist accident victims.
• One such service known as "Sanjeevini" in Bangalore, Mysore,
Tumkur and Shivamoga provides 24/7 assistance through its fleet of
ambulances, trained personnel and equipment. These ambulances
have ICU care equipment which is crucial for saving lives.
• However, it is important for all citizens to be aware of helpline
numbers for saving the lives of trauma victims.
• In India, ambulance helpline is 102 and medical helpline is 108
(Andhra Pradesh, Gujarat, Uttarakhand, Goa, Tamil Nadu, Rajasthan,
Karnataka, Assam, Maharashtra, Meghalaya, Madhya Pradesh and
Uttar Pradesh).
• New Delhi has a Centralized Accident and Trauma Services (CATS)
helpline - 1099.

11. • World trauma day is an opportunity for Indian health care authorities
including central and state health secretariats to boost measures
for trauma and accident care. Public health care needs to gear up
better to deal with accidents and traumas.
• Bureaucratic delays in government hospitals must be eliminated to
provide immediate emergency services. In big cities like Mumbai,
Delhi, Chennai, Bangalore and Hyderabad; the choking traffic often
delays critical care interventions.
• There is a need to consider the use of airlifting via helicopters in
severe cases.
• The critical need of the hour in India is public health education to
inform citizens on the do's and don'ts during trauma and accidents.

12. • Road designing plays an important role in preventing trauma. But the rate
of injuries due to trauma cannot only be reduced by adequate road
designing. It is the duty of every citizen of every country to act responsibly.
Remember, prevention is always better than cure. Trauma is no accident. It
can be easily prevented by staying alert. So, help yourself as well as others
by acting responsibly.
• In India, hospitals and other health care organizations usually organize
public information programs on world trauma day to sensitize people on
the dangers of injuries and accidents. Such public service programs are of
utmost importance for the general public who are largely ignorant. More
people should be given first-aid training to be able to support accident and
trauma victims when they come across such cases. As a citizen, it is a duty
to help such victims and not walk away with apathy. Remember that next
time it could be any of us!

13. DO’S & DON’TS
With low levels of awareness and lack of basic first-aid training, citizens
are often confused what to do when they witness an accident. Some
tips to educate citizens include:
Do not move the injured person yourself. Wait for medical help to
transport the person in an ambulance
Call the nearest police station and ambulance service
Do not crowd around the injured person
Loosen any tight clothes like neck tie
Do not give the injured person water to drink immediately. He/she
may choke

14. • Points to remember:
Do's
Follow the road safety rules carefully.
Pay close attention to the warning signs and traffic signals while driving.
Always wear a helmet while riding a two-wheeler.
Avoid distractions like mobile phones and loud music while on road.
Take short breaks in case of long, continuous driving.
Keep your children away from electric switches and wires, sharp objects and
medications.
Always keep a first aid safety kit at your home and in your vehicle.
Ensure that your stairs, windows, balconies and roofs are secure in order to
prevent falls.
Learn basic life support techniques and help the injured.

15. Don’ts
Do not drive when you are tired, sleepy or drunk.
Do not take any risks while driving, in case you are in a hurry.
Do not operate hazardous machinery.
In case of a head or spinal injury, do not move the person from the
site of accident without any professional's help. Moving the injured
person may cause serious back or neck injuries.
Do not give fluids to any unconscious or semi-conscious traumatized
person.

16. CLASSIFICATION
• MINOR TRAUMA- It means an employment injury or an occupational
disease for which first aid or medical treatment is provided and
excludes a disabling injury.
• MAJOR TRAUMA - It means a injury that has the potential to cause
prolonged disability or death.

17. MECHANISMOF INJURY
BLUNT TRAUMA
• Motor vehicle collisions
• Pedestrian v/s vehicle
• Falls

18. COMPRESSION
INJURY (cells in the
tissue are compressed
and crushed)
• Frontal brain contusion
• Pneumothorax
• Rupture of left
hemidiaphragm
• Small bowel rupture
• Chance fracture

19. DECELERATION INJURY
(impact injury to a body
within upon a rapid
moving object caused by
a moving object)
• Aortic tear
• Acute subdural brain
hematoma
• Kidney avulsions
• Splenic pedicle

20. OVERPRESSURE/BLAST
INJURY
• Body cavity compressed at a rate
faster than the tissue around it,
resulting in the rupture of the
closed space
• E.g. – eardrum rupture, lung injury

21. PENETRATING TYPE
• Gun shot wound
• Stab wound
• Impalement (the
penetration of a human
by an object such as
stake, spear, hook to
torture a person)

22.  SPECIAL SITUATIONS
• Explosions –
blunt + penetrate + burns
• Burns
• Crush injuries
• Hypothermia / exposure

23. Most common injuries in a road traffic accident
Brain and head injuries
Neck injuries
Spinal cord injuries
Back injuries

24. GOLDEN HOUR DURING TRAUMA
The term golden hour or golden time is the period
following a traumatic injury during which there is a
high chance that proper medical or surgical
treatment will prevent death.

25. SURVEYS
PRIMARY SURVEY
SECONDARY SURVEY

26. PRIMARY SURVEY
• Pulse oximetry
• Respiratory rate
• Blood pressure
• Blood loss
• Chest x-ray
• Pelvis x-ray
• Catheters
• Focused abdominal sonogram for trauma (FAST)

27. SECONDARY SURVEY
• CT Scan
• Contrast Studies
• Extremity Xray
• Endoscopy
• Ultrasonography

28. ASSESSMENT OF THE INJURED PATIENT
A - Airway and cervical spine
B - Breathing
C - Circulation and hemorrhage control
D -S Disability or Dysfunction of the Central Nervous System
E - Exposure

29.  AIRWAY AND CERVICAL SPINE
• Always assume that patient has
cervical spine injury.
• If patient can talk then he is able to
maintain own airway.
• If airway compromised initially
attempt a chin lift and clear airway
of foreign bodies.
• Intubate or cricothyroidotomy.
• Give 100% Oxygen.

30.  BREATHING
• Check the position of trachea,
respiratory rate and air entry.
• If clinical evidence of tension
pneumothorax will need
immediate relief.
• Place venous cannula through
second intercostal space in the
mid-clavicular line.
• If open chest wound seal with
occlusive dressing.

31.  CIRCULATION AND HEMORRHAGE
CONTROL
• Assess pulse, capillary return
and state neck veins.
• Identify exsanguinating
hemorrhage and apply direct
pressure.
• Place two large caliber
intravenous cannulas
Give intravenous fluids
• Attach patient to ECG monitor.

32.  Disability or Dysfunction of the
Central Nervous System
• Rapid assessment of
neurologic status to identify
life-threatening injury.
• Pupil size and response.
• Mental status (GLASGOW
COMA SCALE)
• Motor and Sensory exam.

33.  Exposure
• Head to toe examination of the patient for injury.
• Pitfalls
Prevention of Heat loss
Maintenance of spine precautions
• Undress the patient completely but prevent hypothermia.
• Logrolling and looking for back of the patient is very important.

34. THINGS EVERYONE SHOULD CARRY IN THEIR FIRST AID
BOX
• Gloves - to protect you when having to give first aid to anyone bleeding
• Face Shield - if you are required to give CPR to anyone, it’s good to have a barrier
to prevent infection
• Triangular Bandage - can be used as a sling or a pad to stem bleeding
• Crepe Bandage - used to create pressure on wounds, reducing swelling or to
hold padding in place
• Non-adherent dressings - used to covered abrasions
• Band-Aids - for small wounds
• Gauze - to clean wounds (only swipe in 1 direction and use once to keep wound
clean)
• Saline Solution - to help clean wounds
• Pencil & Note Paper - to note details while you’re on the phone, or to go with
the casualty to the hospital
Carrying these items in waterproof or zip lock bag means they will be ready in
any weather condition.

35. Shocking facts
1. 22.8 per cent of all traumas are transport-related injuries.
2. India accounts for one-fifth of global deaths due to road accidents.
3. A trauma-related death occurs in India every 1.9 minutes.
4. It is estimated that 1million people die and 20 million are hospitalized
every year due to injuries.
5. A vehicular accident is reported every 2 minutes and a death every 8
minutes on Indian roads.
6. According to National Crime Records Bureau (NCRB), about 1,37,000
people died in road accidents in the nation in 2013.
7. Most of the people who pass away are young males who are the earning
members of the family.
8. In the country, deaths due to trauma exceeded those due to cancer and
heart diseases combined.
9. Road-traffic accidents are increasing at annual rate of 3 per cent every
year.

36. THANKYOU