Traumatic injury is a term which refers to physical injuries of sudden onset and severity which require

immediate medical attention. The insult may cause systemic shock called “shock trauma”, and may
require immediate resuscitation and interventions to save life and limb. Traumatic injuries are the result of
a wide variety of blunt, penetrating and burn mechanisms. They include motor vehicle collisions, sports
injuries, falls, natural disasters and a multitude of other physical injuries which can occur at home, on the
street, or while at work and require immediate care.

Many accidents resulting in traumatic injury can be treated appropriately in hospital emergency
departments. More severe and multiple traumatic injuries may be triaged by the 911 responding
ambulance or helicopter flight teams as a Trauma Alert. A Level One Trauma Alert is a determination
based on a rapid physical assessment of the victim’s immediate medical needs. Based on trauma alert
criteria, first responders deliver the patient to the most appropriate hospital.

Trauma guidelines in the U.S. were first established in 1976, and an efficient sophisticated trauma
network now serves us all wherever we live, work or travel. Hospitals are accredited and designated as
Level I, II, III or IV Trauma Centers based on the care they are able to provide, as well as the volumes
they serve, urban and rural. The trauma system is designed to accommodate mass casualties and
disaster situations. Level I Centers provide the highest level of care with optimal resources and
capabilities, staff and specialties around-the-clock, and are continuously monitored to assure that they
meet or exceed national standards. Trauma centers work closely with their respective EMS systems so
that care begins pre-hospital.

Critically injured patients deemed a Trauma Alert will be delivered to a resuscitation area which may look
more like an operating room than a traditional emergency department. In this environment, a highly-
skilled professional trauma team is ready to provide immediate life-saving procedures in state-of-the-art
trauma bays. Research shows that getting to the right place at the right time, commonly known as the
“Golden Hour” or first 60 minutes after the occurrence of a major multi-system trauma, is critical. Adult
and pediatric trauma surgeons, trauma staff and resources are ready and dedicated 24/7 to provide this
unique level of response so that critically injured patients will have the best possible chance of survival
and the least residual disability from their injuries.

Following care in the trauma resuscitation area at a Level One facility, patients may proceed to surgery,
an intensive care unit or the trauma nursing floor, with all the resources and services of the hospital
available in a true multi-disciplinary fashion. Patients brought to Level II-IV centers may remain at that
hospital or be transferred to a higher level of care as appropriate.

Types of Traumatic Injuries

Some common type of traumatic injuries include, but are not limited to:
 Traumatic brain injury
 Spinal cord injury
 Spine fractures
 Amputation - traumatic
 Facial trauma
 Acoustic trauma
 Crush injury
 Concussion
 Broken bone
 Jaw - Broken or dislocated
 Skull fracture
 Cuts and puncture wounds
 Collapsed lung
 Myocardial contusion
 Burns
 Electrical injury
 Hypovolemic shock
 Subarachnoid hemorrhage
 Subdural hematoma

Injury Severity Score (ISS)

The Injury Severity Score is an established medical score to assess trauma severity. It correlates with
mortality, morbidity and hospitalization time after trauma. It is used to define the term major trauma. The
ISS classifies each injury in every body region according to its relative severity on a six point ordinal
scale:

1. Minor
2. Moderate
3. Serious
4. Severe
5. Critical
6. Maximal (currently untreatable).
There are six body regions:

1. Head / Neck
2. Face
3. Thorax
4. Abdomen / Pelvis
5. Extremities
6. External
UF Health is a designated Level One Trauma Center which provides the highest level of adult and
pediatric comprehensive trauma care, around-the-clock, for any and all accidents and injuries. Traumatic
injuries are the result of a wide variety of blunt, penetrating and burn mechanisms. They include motor
vehicle collisions, sports injuries, falls, natural disasters and a multitude of other physical injuries which
can occur at home, on the street, or while at work and require immediate care.

Many traumatic injuries will be treated in the UF Health Emergency Department, while more critical
injuries may be triaged by the ambulance or helicopter team as a Trauma Alert. These patients are
brought directly into the Level One trauma resuscitation area where a highly-skilled professional trauma
team is ready to provide immediate life-saving procedures in state-of-the-art trauma bays. Research
shows that getting to the right place at the right time, commonly known as the “Golden Hour” or first 60
minutes after the occurrence of a major multi-system trauma, is critical. The UF Health adult and pediatric
trauma surgeons, trauma staff and resources are dedicated 24/7 to provide this unique level of care so
that critically injured patients will have the best possible chance of survival and the least residual disability
from their injuries.

Following care in the trauma resuscitation area, patients may proceed to surgery, an intensive care unit or
the trauma nursing floor, with all the resources and services of UF Health Shands Hospital available in a
true multi-disciplinary fashion. Additionally, many trauma patients are transferred to Shands following
immediate care at outside emergency departments for definitive care by our trauma and specialty teams.

UF Health has a long and rich history of commitment to trauma care, and has treated over 20,000 trauma
patients since attaining Level One status. We look forward to continue serving our growing communities
and provide a full continuum of trauma care and resources for you and your loved ones.

COMMON EXPERIENCES IN PARENTS FOLLOWING THEIR CHILD’S PHYSICAL

TRAUMA
Dr Jennifer Dainty works as a Clinical Psychologist within a large children’s hospital in the UK.
One of her main roles within the trauma service is to support families when a child is in hospital
following a traumatic event. She has kindly provided the following advice to parents whose
child has been seriously injured.

"As part of my clinical psychology qualification, I conducted a piece of research exploring the
impact of a child’s physical trauma on parents’ psychological well-being. I conducted this study
as I feel it is vital for clinicians to understand families’ experiences of traumatic events in order
for us to optimise the support we can provide both in and out of hospital.

The outcomes of the research highlighted that there is often a significant impact on parents’
psychological well-being following trauma to their child, including low mood and post-traumatic
stress symptoms such as flashbacks, heightened anxiety and sleeplessness. Most parents
described experiencing a number of these symptoms when their child was in hospital, which
continued for a period of time following discharge. When I interviewed parents, all parents in
the study described feeling a level of guilt and responsibility, which can understandably be
extremely distressing for parents. Mothers, fathers and step-parents all tended to cope in their
own ways and each parent described often coping differently to their partners, which could
sometimes cause conflict. At other times, parents felt closer to each other as a result of this
shared, though distressing experience. Importantly, it was highlighted that all parents coped in
different ways, though there were many common experiences regarding psychological impacts.

During the interviews, most parents felt that their feelings of anxiety and low mood, as well as
other symptoms of post-traumatic stress were gradually lessening as time went on. Support
from families, friends and communities was highlighted as an important factor in coping.
Children’s resilience was also felt to be helpful for parents when trying to cope with their own
difficult feelings.

Throughout this research and from my clinical experience, it is apparent that there can be an
enormous impact on parents’ psychological well-being following a child’s traumatic event and
this is certainly not unusual. Events such as this are understandably difficult for parents to
manage and if you are in this situation, it is important to know that the psychological
repercussions that you may be experiencing are likely to be normal responses to an unexpected
situation. Symptoms tend to reduce over time however some people find it helpful to access
counselling or psychological therapy to help them to process the event when symptoms are not
felt to be reducing. As human beings, we often try to block out unwanted or distressing
thoughts and memories, though by doing this we are not allowing our brain to process our
experiences.

Accepting support from friends and family is something that a lot of people can initially find
difficult to do but parents often tell me that this has been very beneficial once they’ve felt able
to do this. Using the support of people around you to talk through your experience can help
you to process this traumatic event and in time, may help with some of the difficult emotions
that are associated with these experiences.

There is information available on this site regarding post-traumatic stressand other

psychological difficulties following trauma that it may be helpful to read more about. If you feel
that you may be experiencing post-traumatic stress or other psychological difficulties which are
impacting on your life, you may benefit from accessing psychological support which your GP
can refer you for. It is important to remember that what you’re experiencing is normal; we
often just need to give ourselves some time and space to acknowledge what we have been
through to enable us to re-focus on the here and now. "