Managing Multiple-trauma Patient in an Emergency Department: Causes of Injury and Outcome

Abstract

Introduction: Injuries are recognized as an important public health problem, all over the world, which affects the lives of young and healthy adults. Injuries are the third leading cause of mortality in the world, responsible for 5.8 million deaths annually. Road traffic accidents hold a dominant position among different causes of injury, while it is estimated that, globally, the annual cost of road traffic accidents ranges between 1–2% of the Gross Domestic Product (GDP). Aim: The purpose of the study was the recording of data of multiple-trauma patients treated in the Shock Room of an Emergency Department, in search of risk factors for injury, main causes and outcome. Method: This is a retrospective descriptive study with correlations. The sample of the study consisted of 323 multi-trauma patients (convenience sample) treated in the ED’s Shock Room of a big adult hospital in Northern Greece for a period of five years (01.01.2005–31.12.2009). The data were collected from the Shock Room’s patient books, after granted permission from the Scientific and Administrative Board of the hospital, and with the consent of both the ED’s Director and Nurse Manager. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) 19.0. Results: The majority of multiple-trauma patients were men (78%) and mean age was 41.45±21.25 years old. For a 52% of the patients the cause of trauma was road accident, while the 16.7% was caused by fall from height. One hundred forty four patients were transported to a surgical unit, the 24.5% of them to the Intensive Care Unit and the 15% to the Operation Room. The cause of trauma was statistically significantly correlated with the final outcome of the patients (p<0.001, ρ=–0.2), and statistically significant correlation was also found between the final outcome and the season of trauma incidence (p=0.027, ρ=–0.123).On the contrary, no correlation was detected between the cause of trauma and the patient’s age or the season the incident of trauma occurred. Conclusion: It is required that health care professionals, involved in providing care, receive continuous training and education, aiming to reduce disability and to the full recovery of the patients. The role of nurses is highlighted, contributing both to specialized care, as well as to the reduction of road traffic accidents’ incidence, that account for the most common cause of injury in our country, through health promotion programs in schools and community.