Penetrating neck trauma

Penetrating neck injuries are potentially life threatening due to the critical structures contained within the neck. Delayed diagnosis of some serious injuries (eg: oesophageal lacerations) is a significant concern as patients can have minimal initial physical and radiological examination findings. Anatomy From an anatomical point of view, penetrating trauma to Read more…

Traumatic brain injury

Introduction Traumatic brain injury (TBI) is a leading cause of death from trauma and is major cause of disability, especially in children and younger adults.   The 2019/20 NZ National Trauma Networks Annual report identified a caseload of 728 serious traumatic brain injuries over a 12 month period with a Read more…

Secondary survey

After the primary survey is completed and life threats addressed, a systematic secondary survey should be undertaken. This is a complete examination of the patient from top to toe, both front and back. All findings are documented, usually on a standard trauma form.   Head and face Scalp Examine and Read more…

Tension Pneumothorax

Introduction   A tension pneumothorax can occur with blunt or penetrating chest trauma   A laceration to the lung creates a flap-valve – when the patient breathes in, the negative pressure sucks air into the pleural space. The valve traps the air when the patient exhales The increasing intrathoracic air Read more…

Massive Haemothorax

A haemothorax is a collection of blood in the pleural space. It can be caused by penetrating or blunt thoracic trauma.   Massive haemothorax is defined as drainage of >1500 mL of blood on placement of an intercostal catheter or continuing drainage of blood (200 mL/hr for 2-4 hours). Other Read more…

Cardiac tamponade

  Introduction Traumatic cardiac tamponade is most commonly caused from penetrating cardiac injury however may develop with blunt chest trauma.   As the pericardial sac fills with blood, the heart’s ability to pump is compromised with a subsequent drop in cardiac output. The patient will become progressively more shocked eventually Read more…

Flail chest

  A “flail chest” occurs when part of the thoracic wall is fractured in such a way to create a floating segment. For this to occur peripherally, adjacent ribs need to be broken in 2 or more places. A central flail segment occurs when the sternum is separated from the Read more…

Trauma call

A “trauma call” should standardise the in-hospital response to trauma patients. A trauma team is mobilised to receive the patient. Other services (eg: radiology, blood bank etc) may also be notified.     A mandatory trauma call should be placed if any of the following criteria are met   R40 Read more…

Blunt thoracic trauma

Blunt thoracic trauma is a significant cause of morbidity and mortality. Life threats should be identified on the primary survey though some significant injuries (eg: aortic injuries) may not be immediately apparent.   Immediate life threats These should be identified and managed as part of the primary survey tension pneumothorax Read more…