Trauma (Physical Injury)

First aid after an injury

1. Make sure the scene is safe. Do not put yourself in danger.
2. Call 911 or your local emergency number for any serious injury.
3. Stop bleeding: press firmly and continuously on the wound with a cloth or dressing. For life-threatening limb bleeding, a tourniquet placed 2 to 3 inches above the wound can save a life.
4. Check breathing. If the person is not breathing, start CPR if you are trained.
5. Do not move someone with a possible spine injury unless they are in danger. Keep the head and neck still.
6. Keep them warm and calm. Shock and low body temperature worsen outcomes.
7. Do not give food or drink.
8. Support injured limbs in the position found. Do not try to straighten deformed limbs.
9. Cover open wounds with a clean dressing. Do not remove impaled objects.

Types of trauma

Injuries by body region

Head and brain

Signs of a serious head injury include loss of consciousness, confusion, worsening headache, repeated vomiting, seizures, unequal pupils, weakness, or clear fluid from the nose or ears. Concussion can occur without loss of consciousness.

Face

Symptoms of facial trauma include swelling, bruising, nosebleeds, pain, numbness of the cheek or lip, double vision, difficulty opening the mouth, teeth that no longer meet properly, and a flattened cheek or nose. These suggest facial fractures, which may need a CT scan and specialist repair. Facial injuries can also threaten the airway.

Chest

Chest trauma can cause rib fractures, collapsed lung, bleeding into the chest and heart injury. Warning signs include breathlessness, pain on breathing, coughing blood and uneven chest movement.

Trunk and abdominal organs

Trunk trauma covers the chest, abdomen, back and pelvis. A blow to the belly can injure the spleen, liver, kidneys, bowel or bladder. Signs of abdominal trauma and organ injury include belly pain or tenderness, bruising such as seatbelt marks, a swollen belly, blood in the urine, shoulder-tip pain (from blood irritating the diaphragm, especially with spleen injury), and signs of shock. Internal bleeding may not be obvious for hours.

In trauma scoring systems, injuries are often graded by severity (for example, grade 1 to 5 for organ injuries, with higher grades more severe). A "grade 3" trunk or organ injury generally means a moderately serious injury, such as a deeper laceration of an organ, that may need close monitoring or intervention.

Spine

Neck or back pain with numbness, tingling, weakness or loss of bladder control after an injury suggests spinal injury.

Limbs

Fractures, dislocations, tendon and nerve injuries, and vascular injuries. See fracture.

Open injuries of the foot

Puncture wounds through shoes, lawnmower injuries, crush injuries and cuts on the foot have a high risk of infection because of contamination. They need thorough cleaning, assessment for foreign bodies, fractures and tendon damage, a tetanus booster if needed, and sometimes antibiotics. Puncture wounds through sneakers carry a particular risk of Pseudomonas infection. People with diabetes need especially careful wound care.

Crush injuries: signs and symptoms

A crush injury occurs when part of the body is compressed by heavy force. Signs include:

• severe pain, swelling, bruising and tense, firm muscles
• numbness, tingling or weakness
• skin that is pale, cold or blistered
• dark urine from muscle breakdown

When the pressure is released after a long entrapment, toxins from damaged muscle can enter the bloodstream (crush syndrome), causing dangerous high potassium, kidney failure and shock. Emergency teams often start IV fluids before freeing a trapped person.

Hospital assessment and treatment

Trauma teams follow a structured approach: Airway with spine protection, Breathing, Circulation with bleeding control, Disability (brain function), and Exposure to find all injuries.

• Imaging: X-rays, ultrasound (FAST scan for blood in the belly or around the heart), and CT scans
• Blood transfusion for hemorrhagic shock
• Surgery to control bleeding, repair organs and fix fractures
• Interventional radiology to block bleeding vessels
• Intensive care
• Tetanus prevention and antibiotics for contaminated wounds
• Rehabilitation with physical, occupational and speech therapy

Recovery and long-term effects

Recovery depends on injury severity. Many people recover fully. Others have lasting pain, disability, or psychological effects such as anxiety, depression and post-traumatic stress, which are common after serious injury and treatable.

Prevention

• Wear seatbelts and use child car seats.
• Wear helmets for cycling, motorcycling and contact sports.
• Prevent falls in older adults with strength and balance exercise, home safety changes and medicine reviews.
• Never drive after alcohol or drugs.
• Store firearms locked and unloaded.

Frequently asked questions

What is trauma in medical terms?

In medicine, trauma means physical injury caused by an external force, such as a fall, car crash, blow, crush, burn or penetrating wound. Major trauma refers to serious or multiple injuries that could cause death or long-term disability and need specialist trauma care.

What are the signs and symptoms of a crush injury?

Signs include severe pain, swelling, tense muscles, bruising, numbness or weakness, and pale or cold skin in the affected area. Dark urine suggests muscle breakdown. After long entrapment, release can cause crush syndrome with high potassium and kidney failure, so emergency care is essential.

What are the symptoms of facial trauma?

Symptoms include swelling, bruising, pain, nosebleeds, numbness of the cheek or lip, double vision, difficulty opening the mouth and a bite that feels different. These can signal facial fractures. Breathing difficulty, heavy bleeding or loss of consciousness need emergency care.

What is organ trauma?

Organ trauma is injury to internal organs such as the spleen, liver, kidneys, lungs, heart, bowel or bladder, usually from a blow, crash or penetrating wound. It can cause internal bleeding with few visible signs at first, so belly or chest pain after an injury needs urgent assessment.