Trauma Block (GNK 583)

This fifth year block aims at providing the medical student with a thorough knowledge of how to handle patients who have fallen victim to trauma.  Trauma may be defined as the sustaining of any physical injury, whether it be soft tissue injuries (like abrasions, lacerations, avulsions or burns), crush injuries, exposure to a poisonous substance or fractures of bones.  Trauma is extremely common and is usually caused by motor vehicle accidents, fires, falls and exposure to a venomous animal or plant.  Trauma resulting from illicit acts such as assault, rape and attempted murder are unfortunately not uncommon in South Africa.  Emergency departments at hospitals are usually confronted with victims of trauma, and it is therefore essential to have a good understanding of how to deal with any type of trauma.

Contents of the block:

The block consists of two modules, one practical and the other theoretical.

The objective of the trauma practicals is to introduce students to clinical recognition of trauma emergencies, institution of emergency resuscitation, application of life saving and life support manoeuvres and emergency treatment of the trauma victim. Using actors/models, students are taught the application of the Advanced trauma life support (ATLS) (ABCDE) type approach to trauma.

The trauma theory comprises the introduction to the full spectrum of trauma as a disease. Epidemiology of trauma, mechanisms of wounding, including ballistics, the biological response to trauma, wound healing and complications of trauma will be taught. Emergency treatment, resuscitation and intensive care treatment of the trauma victim will be covered. A systematic course on a thematic basis will be given to cover the major organ systems prioritised according to the ATLS type approach of life threatening, limb threatening or disfiguring injuries.

Thus, thoracic, cardiovascular, abdominal, head and neck trauma will be dealt with as potential life threatening injuries, orthopaedic as limb threatening trauma and skin injuries are mainly disfiguring. Thermal, electrical and chemical burns and hypothermia will be covered. Introduction to physical and psychological rehabilitation and nutrition of the trauma victim will be taught. 

The Skills Lab plays a pivotal role in the successful outcome of the module.  Skills such as how to assess an airway for functionality, securing an open airway, establishing a definitive airway, how to administer oxygen therapy, monitoring oxygenation and ventilation and the method used to intubate patients are taught in the first week of the block.

At the end of the second week, the student will be able to establish intravenous access, recognize the cause of shock in a specific trauma victim, identify and manage possible fatal chest injuries and interpret thoracic x-rays.