Talk:Major trauma/Archive 1

This
This article refers to the meaning of "trauma" used by medical providers: if the patient is "a trauma", it means they've suffered a serious trauma. But literally, physical trauma can refer to any injury, even the trauma caused by a needle stick. I think the article should be changed to reflect that, with the current text being a subsection. Any other thoughts? delldot | talk 05:25, 11 December 2005 (UTC)


 * I say we move it to Trauma (medicine) Doc James  (talk · contribs · email) 22:14, 28 July 2010 (UTC)

That article does not to appear to exist anymore, if it did. But, yes, isn't breaking your arm trauma, even though in most cases it can be healed and be fully functional again. The snare (talk) 11:22, 3 June 2016 (UTC)

Top importance
As one of the leading causes of preventable death should be of top importance. Doc James (talk · contribs · email) 17:06, 25 December 2009 (UTC)

Photo
Should the first photo be changed, the description of it on this page says the patient is unconscious, but they look conscious. Also the description of the photo by the author states the woman collapsed... not really trauma.. just an idea, Tannim101 (talk) 22:17, 27 April 2010 (UTC)


 * Agree Doc James  (talk · contribs · email) 23:48, 27 April 2010 (UTC)

"Causes" Table
The table shows US data, the graph shows Denmark data - What should we do about this? Can someone make a US graph? Peter.C •  talk  15:22, 29 July 2010 (UTC)


 * Yes google documents is good at doing this. Just put it in a spread sheet and it will generate nice graphs. Doc James  (talk · contribs · email) 22:16, 29 July 2010 (UTC)
 * Where could I find a list of traumatic injuries in comparison to age? Peter.C  •  talk  23:06, 29 July 2010 (UTC)
 * It is discussed a bit here List_of_preventable_causes_of_death if you are referring to causes of death from types of trauma by age. Doc James  (talk · contribs · email) 00:41, 16 September 2010 (UTC)

Requested move

 * The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section. 

The result of the move request was: Article not moved. The consensus is that article should stay at this name.  GB fan  11:44, 22 September 2010 (UTC)

Trauma (medicine) → Physical trauma — The article is chiefly about physical trauma, not any other (e.g., psychological, etc.) — Mike moral  ♪♫  22:50, 12 September 2010 (UTC)

Survey

 * Feel free to state your position on the renaming proposal by beginning a new line in this section with  or  , then sign your comment with  . Since polling is not a substitute for discussion, please explain your reasons, taking into account Wikipedia's policy on article titles.


 * Support Conveys the topic and disambiguates correctly. Current title does not distinguish "physical" trauma part well enough. — HELL KNOWZ  ▎TALK 23:34, 12 September 2010 (UTC)


 * Support because the article is about physical trauma specifically. 69.3.72.9 (talk) 01:25, 13 September 2010 (UTC)


 * Oppose Physical trauma is any physical assault that damages tissues. The terminology Trauma is used in the literature to refer to a significant event.  Thus better Trauma (medicine) IMO. Physical trauma is no different from injury for which we already have a page.  Thus Uptodate refers to Trauma management not physical trauma management.   Doc James  (talk · contribs · email) 23:53, 15 September 2010 (UTC)


 * Comment - Injury was very recently redirected to this article. --Kvng (talk) 19:26, 17 September 2010 (UTC)


 * Oppose Per Doc James - the only doc in this discussion Peter.C  •  talk  00:27, 16 September 2010 (UTC)

Discussion

 * Any additional comments: — Mike moral  ♪♫  22:49, 12 September 2010 (UTC)

My argument is just based on the fact that this is how we us the term in the clinical environment. We have trauma surgeons, trauma.org, the journal called Trauma, trauma patients. Yes psychological trauma can result from trauma and should eventually be touched upon during our editing maybe under signs and symptoms? We could could the title to Trauma (physical) instead of Trauma (medicine) but PTSD is considered during trauma care. Doc James (talk · contribs · email) 00:35, 16 September 2010 (UTC)


 * Rosens includes violence and abuse in their section on trauma. Have been unable to find a nice concise definition of trauma yet. Doc James  (talk · contribs · email) 01:29, 16 September 2010 (UTC)


 * Trauma and injury are in fact used interchangeably in the literature therefore I propose we merge these. Doc James  (talk · contribs · email) 01:33, 16 September 2010 (UTC)


 * Seems like a good idea especially since Injury is such a crummy article :P Peter.C  •  talk  01:38, 16 September 2010 (UTC)


 * Actually that seems the best course of action. — HELL KNOWZ  ▎TALK 11:13, 16 September 2010 (UTC)

I think the purpose of this proposal to move the article, that is change the name, is to clarify that the article scope is physical trauma. Mention of other types of trauma would then be removed from this article to other articles. Regardless of whether this article is merged with the article now at Injury, moving this article to a new page name still has merit. "Injury" is about as vague as "trauma" is. 69.3.72.249 (talk) 04:20, 17 September 2010 (UTC)
 * I hope that this page with work will be an overview of trauma from a medical perspective mirroring how the topic is dealt with in the medical literature. Doc James  (talk · contribs · email) 16:04, 17 September 2010 (UTC)


 * Are there good references to justify a move? Which does the literature refer to this topic as more frequently trauma or physical trauma? Doc James  (talk · contribs · email) 22:12, 17 September 2010 (UTC)


 * According to my EMS textbook (Emergency Care 11th Edition) any cut - ranging from a minor bleeding to severe bleeding - is a traumatic injury. But it is only a traumatic injury if it was caused by a fall, a penetrating object and/or a blunt force trauma. If I am correct then a injury is falls under this article (correct me if needed, I am still a fourteen year old kid with no emergency medical experience(yet)) Peter.C  •  talk  20:35, 20 September 2010 (UTC)


 * The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

The Merger
Should we remove the "in other animals" section? I don't think people looking at trauma are looking for that Peter.C  •  talk  10:15, 16 September 2010 (UTC)
 * Agree and done. Doc James (talk · contribs · email) 10:29, 16 September 2010 (UTC)

Headings
I have added level three headings to make it easier to expand content under them. Please expand the content rather than remove the headings. Doc James (talk · contribs · email) 19:28, 19 September 2010 (UTC)

Burn injuries
Burn injuries should be included in this article. If burns are not considered traumatic injuries, then why do the Advanced Trauma Life Support manual and other texts on traumatology dedicate so much attention to them? DiverDave (talk) 19:10, 30 October 2010 (UTC)

"Injury" DAB page needed
"Injury" redirects here but unlike "trauma" doesnt have its own DAB page.--Penbat (talk) 22:20, 30 November 2010 (UTC)

Copyedit
I performed a major copyedit on this article to improve overall readability and grammar. I believe this article now qualifies for WP:GA! Congratulations to everyone for all their hard work in making this article as informative and as useful as it is. <3 ♥ Solarra ♥  ♪ Talk ♪  ߷  ♀ Contribs ♀ 12:32, 19 June 2012 (UTC)
 * Being one of the major contributors I do not think this article is at GA yet. B quality sure but not yet GA. I will work on it further eventually. Doc James (talk · contribs · email) 04:45, 20 June 2012 (UTC)

Epidemiology
I saw this at WP:GAN and considered reviewing it. But I'm concerned about its accuracy, so I wanted to post this now:

I'm not so sure about this claim that injury is the leading cause of death for people under age 45 worldwide. I can confirm that it is the leading cause of death in the US and for people ages 1 to 44, but not "worldwide" and not for every age group "under 45". This says that trauma is only the fifth leading cause of death for infants (under age 1) in the US.

It also depends on how you divide the categories. For example, do you separate HIV/AIDS from malaria, or lump them all together in one big "communicable disease" category? But even if you subdivide, it doesn't seem to be correct. Table 5a of this WHO report says that children ages 0 to 14 die from injuries (including poisoning, which isn't really trauma), but  die from childbirth problems and  die from respiratory infection,  die from diarrhea.

So it seems to me that the leading cause of death worldwide isn't injuries for the age groups named. There's a string of inline citations behind this, but the ones I was able to check easily don't seem to make "worldwide" claims. WhatamIdoing (talk) 23:01, 23 June 2012 (UTC)
 * Yes. Before it state leading preventable cause of death under 45 but the "preventable" was lost along the way. Have added a better ref that states 15-45 which takes into account the evidence you mention. Doc James (talk · contribs · email)(please leave replies on my talk page) 23:36, 23 June 2012 (UTC)

Some style notes
I'm no doctor, but User:Peter.C asked me to have a look at this article informally. I've got a few suggestions regarding style.

"While falling accidents, a subset of blunt trauma, are the second most common cause of traumatic death."

This sentence seems to follow on very strangely from the previous sentence. Usually, one starts sentences with 'while' because one is planning to go on and contrast the first fact presented with something else in order to make a comparison or to point out the seeming incompatibility etc. (while X is the case, Y is also the case). You might want to think about what you are trying to say here.

"By identifying risk factors present within a community and creating solutions to decrease the incidence of injury"

This sort of makes sense but could be simplified a lot.

"After ensuring their own safety and taking isolation precautions, a primary survey is performed, consisting of checking and treating airway, breathing, and circulation then performing an assessment on the level of consciousness."

This should probably be rephrased to say that paramedics or doctors or whoever ensure their own safety and then perform a primary survey.

"In 2009 around 693.5 billion USD was lost due to injury in the United States"

Is this there for context? How does it relate to trauma?

I hope this helps. —Tom Morris (talk) 14:56, 18 July 2012 (UTC)

Link at the top to psychological trauma?
Shouldn't there be a disambiguation link at the top to psychological trauma?Bstone1 (talk) 02:30, 9 September 2012 (UTC)
 * There already is a link to it at the top of the page. Also, I removed mention of psychological trauma as it does not relate to this article. Peter.C  •  talk  •  contribs  02:58, 9 September 2012 (UTC)
 * Psychological trauma isn't covered under the umbrella of medical trauma? Also, you're referring to the trauma disambiguation page.  I think there should be a specific link to the page on psychological trauma.  Also, it looks like you reverted the edits.  I suppose the question does medical trauma cover both physiological and psychological trauma also answers the question of what should be in the intro.


 * As for the question of definition, while I'm not a medical professional, what is your objection to the statement that trauma is damage done by an external action? Isn't trauma a term used to demarc the dichotomy between injury caused by external forces and internal?  The best option seems to be renaming this article.Bstone1 (talk) 03:23, 9 September 2012 (UTC)
 * A move was previously discussed here and was opposed, and the discussion answers some questions you propose. Peter.C  •  talk  •  contribs  03:53, 9 September 2012 (UTC)
 * The move discussed was between physical trauma and trauma (medical). The dissent was that physical trauma is a subset of general physiological trauma.  I'm suggesting that the name be changed to trauma (physiological), which sidesteps that issue.Bstone1 (talk) 05:08, 9 September 2012 (UTC)

Requested move September 2012

 * The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section. 

The result of the move request was: Not moved Mike Cline (talk) 19:39, 19 September 2012 (UTC)

Trauma (medicine) → Trauma (physiological) – Medical trauma can be either physiological or psychological. Also, physical trauma is a subset of general physiological trauma. As this article is about physiological rather than psychological, and medical trauma covers both physiological and psychological it seems appropriate to rename this article Trauma (physiological)Bstone1 (talk) 00:32, 10 September 2012 (UTC)


 * I don't think this is such a good idea. We need something that is precise enough, without using six-syllable words unnecessarily.  What we have already is good enough.  WhatamIdoing (talk) 02:32, 12 September 2012 (UTC)
 * Agree we do not need to move it. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:52, 12 September 2012 (UTC)


 * The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Israeli trauma scales
(copied the info from a personal talk page)

I've added the sevirity scale that is used by MDA, Hatzalah , Israeli MEDevac and private EMS

The information had been taken from :


 * scale defenition page 5 (defention for injury scale) that is defently a WP:RS
 * Israeli center beru of statisics referning that scale in traffic acidents
 * Mako news agency (which can be counted as WP:RS).
 * Dr. A. Wiveser answering for defenition of severity scale in a medical forum
 * the hebrew page for trauma page

Here are examples of usage in English ( trafic accidents related ) for this scale:


 * http://www.cbs.gov.il/reader/Milon/Milon_ByTerm_E.html?OnlyFinal=1&MyID=227&IdContext=26
 * http://www.cbs.gov.il/reader/Milon/Milon_ByTerm_E.html?MyID=225&OnlyFinal=1

Examples for the media (in the English language using that scale) -


 *  three others sustain lightly injuries when Palestinian
 * sustained light to moderate injuries.
 * 'Three people died from poisoning cases reported in 2011, while 176 suffered serious injury and 692 suffered moderate injury; 8,384 were lightly injured. The others either exhibited no effects or information is not available about the extent of their injuries.'
 *  in intensive care with a moderate injury from a shard that penetrated the area near his stomach. Beyar said Batlin and his friend "arrived bandaged and had received reasonable care in Bulgaria." 

That scale is an offical scale that is also use by the Israeli CBS (here an example traffic acidents by sevirty of the innjury) and media reporting in Israel

Yet it had been removed, afaik the rule for non English source is to accept when no other can be found. I understand that my text could language issues and I belive that can be ok, yet to remove an offial scale just becouse it is in a diffrent language and used outside of English speaking countries is a mistake. — Preceding unsigned comment added by 109.226.26.130 (talk) 19:07, 11 October 2012 (UTC)
 * I removed it because it appeared to be a direct translation from the original source. I highly encourage you to reinsert it into the article, but please bear in mind not to plagiarize and to ensure your edits to this article are inline with WP:MEDMOS Peter.C  •  talk  •  contribs  20:24, 11 October 2012 (UTC)
 * Thank you for your replay, I've reinserted it after reading WP:MEDMOS 109.226.26.130 (talk) 08:11, 12 October 2012 (UTC)

Injury Scales
Should we create injury scale as an article, and replace the current text we have in this article with a nice paragraph about the purpose and various implementations of injury scales? Thoughts, questions, concerns? Peter.C •  talk  •  contribs  11:06, 12 December 2012 (UTC)


 * Support There is category:Orthopedic clinical prediction rules which has NACA/ISS/RTS, but yes there is no article on the subject Mschamberlain (talk) 22:04, 9 July 2014 (UTC)

Orphaned references in Trauma (medicine)
I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Trauma (medicine)'s orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "manual": From Heart:  From Diagnostic peritoneal lavage:  From Benzodiazepine:  From Spinal cord injury:  

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT ⚡ 19:01, 31 December 2012 (UTC)

Trauma/injury redirection debate
Mschamberlain (talk) 22:01, 9 July 2014 (UTC)

Potentially useful images of massive trauma training dummies
Hi Would these images be useful in this article? They are of training dummies.

Mrjohncummings (talk) 16:54, 26 February 2015 (UTC)
 * Wow impressive. Maybe the black and white one. We do not want to shock unnecessarily Doc James  (talk · contribs · email) 20:05, 26 February 2015 (UTC)
 * Yes I tried to use dummy as many times as I could in my message to make sure people weren't shocked, it looks quite realistic (I'm guessing). Mrjohncummings (talk) 23:20, 26 February 2015 (UTC)

Coagulopathy
10.1182/blood-2016-01-636423 Blood review. JFW &#124; T@lk  09:17, 29 August 2016 (UTC)

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