© 2009 MTAC Metrolina Trauma Advisory Committee Copyright. All Rights Reserved / Web Design Mike Jordan, RN

Trauma known as the physical injury most commonly occurs as a result of motor-vehicle collisions, shootings, stabbings, explosions, suicides, and falls. Traumatic injury accounts for more than 140,000 U.S. deaths annually and remains the leading cause of death in those 1-44 years of age. Injury was one of the first tribulations man faced. Experienced when he was first introduced to fire, water, weather and predators. Documented cases of trauma have been traced back to the Edwin Smith papyrus, written between 3000 and 1600 BC. Ancient Egypt, dating back as early as 6000 BC, had surgeons who preformed multiple tasks including: amputations, extraction of foreign bodies, and wounds management.

There were multiple texts relating to burn care in the Ebers Papyrus, believed to be written in 156 BC. Sushruta from Ancient India (2500 – 1500BC), described using over 100 surgical instruments. There are also multiple sources from ancient Greece where the father of modern medicine, Hippocrates lived. Surgery was flourishing treating the common injuries of fractures and dislocations and healing wounds. The Romans introduced a system of hospitals using tents in the field for military purposes. The first permanent hospital was built for the public in fifth century AD.

Trauma care was continually growing throughout the Middle Ages to include more methodical processes, regulations to physician’s training, development of licensing examinations, and the insistence of a post graduate year spent with a private physician (Residency). The 18th century brought multiple technological advancements for diagnosis and care. These included cellular pathology, greater understanding of respiration and blood pressure, and invention of artificial ventilation. It was also in this century, that Diminque Jean Larrey developed the “ambulance volante” to fulfill the need for in-field trauma care and a more efficient means for transportation to definitive care.

Even with the influx of many medical advancements, War World I found a 66% mortality rate for abdominal wounds. Improvements were made as rudimentary antibiotics were introduced. World War II had much superior advances in trauma care methods. Blood transfusions were routine and auxiliary centers were placed more proximal to sites where injuries were occurring. In 1938, the American Association for the Surgery of Trauma (AAST) was formed to structure and improve civilian trauma care.

Like advancements made in previous wars, the Korean and Vietnam battlefronts brought about progress in vascular surgery, transport (helicopters) and rapid surgical care for the severely wounded. Civilian Trauma Centers began to emerge and present day comprehensive Trauma Care is guided by such groups as the American College of Surgeons Committee on Trauma and the American Trauma Society.  North Carolina Office of EMS.

Trauma Eipdemiology