Pathophysiology: - trimodal death distribution (1):
- The first peak occurs within seconds to minutes of injury. Deaths generally result from apnea due to severe brain or high spinal cord injury or rupture of the heart, aorta, or other large blood vessels. Very few of these patients can be saved because of the severity of their injuries. Only prevention can significantly reduce this peak of trauma-related deaths.
- The second peak occurs within minutes to several hours following injury. Deaths are usually due to subdural and epidural hematomas, hemopneumothorax, ruptured spleen, lacerations of the liver, pelvic fractures, and/or multiple other injuries associated with significant blood loss.
- The third peak, which occurs several days to weeks after the initial injury, is most often due to sepsis and multiple organ system dysfunction. Care provided during each of the preceding periods impacts on outcomes during this stage.
References: - Advanced Trauma Life Support(R) - Student Course Manual. Ninth Edition. 2012.
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