Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
Know Your Enemy
Trauma, meaning physical injury, is the biggest killer of
young people, and has become an epidemic. Trauma will almost
always result in permanent scars, both physical and
emotional, and often, because it causes many injuries at
once, dangerous conditions can exist which escape our
detection because so much is involved at once.
In Israel all physicians must complete a course in trauma
life support, and all emergency physicians in the USA must as
well. In Israel, special surgeons are certified in trauma
treatment, while many other countries have specialized trauma
centers. Trauma often requires very specialized radiological
studies, and requires the ability to take an unstable trauma
patient immediately to the operating room.
Who is at risk? Naturally old people with illnesses are most
likely to die from trauma, but the following are also high
risk even in the young. Severe head injury, broken neck,
patient ejected from vehicle, car versus pedestrian, car
versus train, crush injury, high falls, bullet injuries, and
water injuries.
Some of these could be preventable by using good common
sense. Ejections from vehicles is usually due to not using
seat belts. Babies not in baby seats, or on the lap of the
driver or passenger are at high risk for tragedy. Head
injuries are much less likely in motorcyclists and bikers who
wear helmets -- that includes children! Broken necks can be
prevented through the use of airbags. Car versus pedestrian
can be prevented by teaching children how to cross the
street, and not walking in the street (a common Israeli
practice). If there is a crossing light, wait for it to turn
green.
We sometimes see unfortunate injuries in industrial sites
from children playing in unfinished buildings or construction
areas. High falls can be prevented by practicing good hiking
safety if you are taking a trip into the country, and in the
house by installing accordion-like fences at the top of the
stairs if you have a crawler at home. Walkers are extremely
dangerous since falls down steps have resulted in
fatalities.
Summer is a great time for swimming, but remember, whether it
be the ocean, pool, a kiddie pool, a river, or even a
bathtub, a child should never be left unattended. Swim at
places with a lifeguard, take a course in life saving, and
use the buddy system of swimming, or leave one member of the
party on land to watch while everyone else swims. Take the
phone off the hook while bathing a little one.
Lastly, rocks are not toys, and neither are cars. Speed
kills, and so does fatigue. Drive defensively, and if you
find your young adult driving in an unsafe manner, don't let
them drive. I hope I don't need to tell any of my readers
that if you have drunk even a small amount of an alcoholic
beverage, stay away from driving.
I don't think I have given you any new information, but if
that was entirely true there would be a lot less trauma.
Write me in care of the Yated.
A note from Glaxo, sponsor of this column: Glaxo
technology has resulted in an antiviral that is effective
against cold sores, chicken pox and the shingles: Valtrex.
Once again, there is hope -- from Glaxo.
