Critical Care Issue in Trauma - 1389 Words

Trauma was the major cause of mortality and morbidity till last 2 decades but after that there have been major improvements in management and resuscitation of trauma patients. This does not imply only to emergency care but also ICU management. It is well established that there is trimodal distribution of death in trauma patients. First peak is within seconds to minutes because of head or cervical spine injury or to injury to major blood vessel and much cannot be done about this. The second peak occurs in minutes to hours due to life threatening injuries and prognosis depends on initial resuscitation of the patients both in the emergency department and ICU.Then there is third peak which occurs several days to weeks and is often due to sepsis and multiorgan dysfunction[1]. This third peak can be prevented by good ICU management of these patients. Here comes the role of good intensivist who has experience in managing trauma patients as trauma patients are different from other patients coming to ICU. There are majorly two kinds of trauma patients coming to ICU; one who are still in the phase of ongoing resuscitation coming directly from the ED or Operation Theatre [OT] after damage control surgery. Secondly there are patients who were being treated in the ward, deteriorated and then shifted to ICU. There are certain problems particularly seen in trauma patients. In this review we will try to highlight certain these problems. 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