Context

Understanding the mechanism of injury is crucial to our clinical decision making for trauma patients during the preparation for arrival and assessment upon arrival stage in Emergency Medicine (ED).

One of the benefits of working in the prehospital environment is direct access to the scene. It is crucial that we gather information here which will allow us to paint an accurate picture for our hospital colleagues, make decision about any necessary critical pre-hospital interventions, and guide speed of extrication (if applicable).

In the ED we have access to prehospital clinicians, and relatives which inpatient teams may not. It is important that the information we gather from these sources is carefully documented to help guide ongoing investigation and management for the patient journey.

Epidemiology

Injury patterns by age and gender

With advancing age, Falls become the most common mechanism of injury in major trauma (majority falls < 2 metres).  Violent assault with or without weapons are most common in those under 60, as are injuries from RTCs. Sporting injuries are most common in those under 16. Overall, traumatic injuries occur more in men than women in the UK.

Mechanism of Injury in Major Trauma (ISS>15) by age group^1,2

Gender in UK Major Trauma³