Chapter 1: Introduction

Question 1

Define Major trauma.

Answer 1

A clinical syndrome induced by injury that has the potential to cause prolonged disability or death

Question 2

What is the criteria for Major Trauma? (6 points)

Answer 2

1. Serious injury to 2 or more body systems
2. Trauma patients with ISS more or equals to 12
3. Trauma patients who succumbed to their injuries after admission
4. Trauma patients admitted to ICU or high dependency area for >24 hours
5. Trauma patients requiring mechanical ventilation
6. Trauma patients who require urgent surgery within 24 hours (intracranial, intra-thoracic, intraabd, pelvis or spine)

Question 3

What is trimodal death distribution?

Answer 3

3 peaks of death that occur among major trauma victims

Question 4

First phase of trimodal. Define and example.

Answer 4

Immediate: seconds to minutes

Exp:
- brain stem injury
- high spinal cord injury
- laceration to heart or great vessel

Question 5

2nd phase of trimodal. Define and exp.

Answer 5

Minutes to hours

Example:
- Hemorrhagic shock
- Life threatening injuries

Question 6

3rd phase of trimodal. Define and example.

Answer 6

Due to complications from injuries

Days to weeks

Exp:
- Multiple organ failure
- Sepsis
- Nosocomial infection

Question 7

What is biomechanics of injury?

Answer 7

The understanding of mechanism, extent of energy transmission, trajectory of impact and surrounding circumstances that lead to injuries

Question 8

What is Malaysian Trauma chain of Survival

Answer 8

Strategic concept which delineates flow and core processes for severely injured trauma victim to undergo from point of injury to recovery.

Question 9

What are the 5 phases of Malaysian Trauma Chain of Survival?

Answer 9

Phase 1: Early activation and Pre-Hospital Trauma care
Phase 2: Trauma life support and Resus
Phase 3: Acute surgical and Interventional care
Phase 4: Intensive and definitive care
Phase 5: Recovery and Rehab