Trauma Emergencies and Trauma Systems
Trauma items emphasize scene safety, hemorrhage control, primary survey, and transport to the right facility within the Kuwait trauma system.
Core rules
- Mechanism matters: energy, restraint use, ejection, pedestrian strike, and fall height guide suspicion of serious injury.
- Control catastrophic external hemorrhage first with direct pressure or a tourniquet; do not delay airway management for minor bleeding.
- Primary survey: airway with cervical spine precaution, breathing (assess for tension pneumothorax, open chest wound), circulation, disability, exposure.
- Spinal motion restriction is selective: use when mechanism or findings suggest instability, not routinely for every patient.
- Permissive hypotension (SBP ~80–90 mmHg) may be used in penetrating torso trauma without traumatic brain injury; avoid hypotension in TBI.
- Burns: stop the burning process, remove jewelry, cover with dry sterile dressings, and estimate TBSA; do not apply ice.
Worked example
A motorcyclist is hypotensive after a high-speed crash. You find a pulseless, swollen thigh and active bleeding. You apply a tourniquet, establish IV access, give a fluid bolus, and transport rapidly to a trauma center. You reassess the tourniquet and vital signs en route.
Traps
Missing tension pneumothorax; ignoring pelvic instability; using spinal boards for prolonged immobilization; and over-resuscitating before hemorrhage control.