Chapter 14. Trauma and Burns

Bennett P deBoisblanc, MD, FCCP
DOI: 10.1378/critcare.21.14
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  • List common organ injuries associated with different types of blunt force and penetrating trauma such as traumatic brain and spinal cord injuries, hemopneumothorax, aortic injury, esophageal injury, bronchial rupture, cardiac contusion, solid organ injury in the abdomen, and pelvic fracture.

  • Identify the preferred diagnostic and management approaches to each of the above injuries and their complications.

  • Identify the common complications and the appropriate management of burn and electrical injuries.


Trauma is the fifth leading cause of death in the United States. Motor vehicle accidents are the major cause of life-threatening blunt force injuries while gunshot wounds lead the list of causes of serious penetrating traumatic injury. Understanding the mechanism of injury is helpful in identifying occult injuries that may be missed on a primary survey. Traumatic brain injury and uncontrolled hemorrhage caused by trauma coagulopathy are the most common mechanisms of death. Damage control resuscitation and damage control surgery have reduced morbidity and mortality of traumatic injuries. Smoke inhalation injury is the most common mechanism of deaths caused by fire. Both low-voltage and high-voltage electrocution can be fatal, but the mechanisms and management are often different.


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