Trauma (medicine)

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In medicine and biology, trauma ( plural trauma or trauma ; ancient Greek τραύμα , ' wound ' ) or injury is a damage or wound to living tissue that is caused by external violence . From a physical point of view, trauma is triggered by a sudden transfer of energy or the sudden withdrawal of heat or oxygen; the energy can act on the body mechanically (e.g. as a result of an accident), thermal ( combustion ), electrical, chemical or radiation. While “trauma” encompasses the entire injury process, the term “ lesion ” is also used for an individual injury . The study of the types of injuries and their treatment is called traumatology .

In a figurative sense, severe mental injuries are also referred to as trauma in medicine and psychology ( ICD-10 F43.1). The adjective "traumatized" is mainly used in this psychological context.

The physical injuries damage the person concerned not only through direct tissue damage (wound, tissue destruction, bone fracture ), but also have indirect effects on the entire organism. A fat embolism , a crush kidney or a release of tissue hormones can result from the loss of blood or from cells detached from the cell network .

Common symptoms of psychological trauma include: loss of orientation, language difficulties, helplessness, fear of failure, change in the image of speech, depression, disinterest, irritability / aggression, recklessness and memory lapses.

Subdivision

A monotrauma is a non-life-threatening individual injury .

A barynx trauma (from the Greek βαρύ bary , German 'heavy' and trauma 'wound') is a serious, life-threatening individual injury, e.g. B. a traumatic brain injury . (This should not be confused with barotrauma , which can result from a sudden change in pressure, e.g. when surfacing too quickly in diving .)

From a trauma one speaks in severe cases of multiple injury that affects several body regions or organs.

Injuries can also be differentiated according to whether they occur intentionally or unintentionally. Unintentional injuries can a. the result of a traffic accident , a sports accident , an animal bite or a fall be as intentional injuries caused by violent crime , war or suicide may arise. In addition, a distinction can be made between blunt and penetrating traumas. a. Gunshot, stabbing and impaling injuries.

Epidemiology

In 2010 5.1 million people worldwide died as a result of injuries, one in ten deaths. 89% of the deaths occurred in countries with a low to medium average income. In countries with high median incomes, injuries are the cause of only 6% of deaths. In general, young people and men are affected much more frequently; more than half of all injury deaths (52%) affect men between the ages of 10 and 25.

Accidental injuries killed 3.5 million people in 2010 (69%), with road traffic victims being the most common (540,000, 28% of all accidental deaths), followed by falls (0.5 million, 11%), drowning (350,000, 7%) ) and exposure to heat (burns, fire, chemical burns; 340,000, 7%). In 2010, natural disasters killed 200,000 people worldwide (4%), self-harm 880,000 (17%), violence 460,000 (10%) and wars 18,000 (<1%).

American trauma centers and Martin Allgöwer's research group in Basel pioneered modern trauma management in the 1970s. Since then, also by moving intensive medical treatment forward to the preclinical phase, the mortality in multiple trauma has decreased from over 60% to under 30%.

See also

Web links

Wiktionary: Trauma  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ^ Robyn Norton, Olive Kobusingye: Injuries . In: New England Journal of Medicine . tape 368 , no. 18 , May 2, 2013, p. 1723-1730 , doi : 10.1056 / NEJMra1109343 .
  2. ^ HJ Oestern, G. Rule: General aspects . In: Harald Tscherne , G. Regel (Ed.): Trauma Surgery. Trauma management . Springer, Berlin 1997, ISBN 3-540-61605-5 , pp. 225-238 .
  3. ↑ Christian Madler, Karl-Walter Jauch, Karl Werdan, Johannes Siegrist, Frank-Gerald Pajonk (eds.): Akutmedizin - The first 24 hours. The NAW book . 4th edition. Urban & Fischer, Munich 2009, ISBN 978-3-437-22511-6 , pp. 817 .
  4. ↑ Rafael Lozano, Mohsen Naghavi, Kyle Foreman, Stephen Lim, Kenji Shibuya: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 . In: The Lancet . tape 380 , no. 9859 , p. 2095–2128 , doi : 10.1016 / s0140-6736 (12) 61728-0 ( elsevier.com [accessed April 17, 2018]).
  5. ↑ Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 469.