Traumatic Injuries and How To Prevent Them

The best way to survive a traumatic accident is not to have one

As medical director of Trauma at L+M Hospital and assistant professor of Surgery at Yale School of Medicine, Stephanie Joyce, MD, sees more than her fair share of people who have suffered serious accidents, including the victims of car crashes and falls.

“What’s heartbreaking in so many cases is how easily the trauma could have been prevented,” Dr. Joyce said. “Some accidents are unavoidable, but riding a motorcycle or bicycle without a helmet, climbing dangerously high on a shaky ladder, drinking and driving – so many of these kinds of serious traumas could be prevented.”

What is a traumatic injury?

Trauma is the number one cause of death for people ages 1 to 46. In the United States, more than 150,000 deaths and more than 3 million non-fatal traumatic injuries occur each year. Trauma is defined as a bodily wound or shock produced by sudden physical injury, such as that from violence or an accident, including vehicle crashes, severe falls, gunshots or knives, blunt force, blasts and burns.

Dr. Joyce and many of her colleagues with Yale New Haven Health have gone public with their concerns about people who drive impaired, whether using alcohol, cannabis or other drugs, and they’ve joined forces with the state of Connecticut’s Not One More campaign to urge people to avoid life-altering accidents.

“The impact of impaired driving is physical, financial and emotional, so it’s really important to realize that one more is never OK,” said Rohit Sangal, MD, associate medical director of the Emergency Department at Yale New Haven Hospital and associate professor of Emergency Medicine at Yale School of Medicine. “When you’re under the influence you’ll make decisions that you wouldn’t normally make, and the consequences of that single decision have profound ripple effects that can be felt for years to come.”

In addition, “these traumatic injuries, in many cases, the people who survive will never fully recover,” said Adrian Maung, MD, medical director for Trauma at Yale New Haven Hospital and associate professor of Surgery at Yale School of Medicine. “A traumatic injury to you or someone else will have psychological and legal implications down the road which can affect people and their families for the rest of their lives. As a trauma surgeon I would like to be out of business, so please, don’t drive impaired.”

How to ‘Stop the Bleed’

Whether a traumatic accident occurs from impaired driving or another cause, individuals can learn skills to help victims at the time of crisis, before professional medical help arrives on the scene. As part of L+M Hospital’s outreach in the community, Dr. Joyce and other caregivers have been holding Stop the Bleed® courses to teach citizens proper techniques for applying tourniquets in different types of situations, and other life saving techniques. “The number one cause of death in a patient who has sustained trauma is bleeding,” Dr. Joyce said. “It’s the thing that will kill you the quickest. A lot of other medical conditions take time, and usually we have time to act on those once the patient is at the hospital. But bleeding can happen in minutes.”

STOP THE BLEED® is a national program run by the American College of Surgeons’ Committee on Trauma, and the program has educated more than 2.4 million people worldwide.

Stop the Bleed teaches people to follow specific steps to save a life:

• Call 911. Getting medical professionals enroute as soon as possible is key.
• Make sure that the patient is in a safe place, including ensuring that the cause of the accident or threat has been eliminated.
• Identify the source of the patient’s bleeding, even if that means removing clothing.
• Compression is next, using gauze or other available fabric. “Once you compress the area, do not keep looking to see if the bleeding has stopped,” Dr. Joyce said. “Just keep pressing.”
• To stop bleeding from the legs or arms, a tourniquet can be used.

Dr. Joyce recommends putting the tourniquet high up on the patient’s extremity (leg or arm), where the arteries and bones are larger and compression of an artery against a bone (to stop the bleeding) is most likely to be effective. Dr. Joyce recommends people buy gauze and tourniquets to keep on hand, perhaps in the car, to use in case of a traumatic injury.

How to avoid falling

Finally, Dr. Joyce and her colleagues encourage people to understand the risks of falls. The statistics are sobering: one in four Americans age 65+ falls each year, and falls are the leading cause of fatal and nonfatal injuries for older Americans, according to the National Council on Aging.

“Many people think falls are a natural part of aging. They are not, and most falls can be prevented,” Dr. Joyce said. “We encourage a variety of approaches to prevent falls, especially for older people. This includes strength and balance exercises, properly managing medications, getting your vision checked regularly, and making your living environment as safe as possible.”

Falls from ladders are also a leading cause of occupational accidents; a ladder safety guide from the Occupational Safety and Health Administration offers a safety overview. “There are thousands of ladder accidents each year, and some are fatal,” Dr. Joyce said. “We urge everyone to take the utmost precaution and to always use ladders only as they are designed to be used.”

Finally, “Traumatic injuries are most often preventable, and we don’t want to have to see you or your loved ones in our hospitals,” Dr. Joyce said. “Think before you act. Take safety precautions, such as wearing seatbelts, and never driving under the influence. Know how to respond in an emergency. Taking these steps can help protect you and your family from the physical and mental agonies that come from trauma. Be safe out there.”