Trimodal Mortality Model and Triage in Trauma

Study Notes

Trimodal Mortality Model for Trauma

Early Death: Occurs within hours of hospital arrival.
- Common causes include intracranial hemorrhage, internal hemorrhage affecting respiratory and abdominal organs, severe blood loss from multiple injuries, tension pneumothorax, and cardiac tamponade.
Immediate Death: Happens within minutes post-injury.
- Typically declared dead at the scene or shortly after arrival due to irreversible brain injury or massive hemorrhage from critical injuries (heart, aorta, liver, lungs, pelvic fractures).
Late Death: Occurs days to weeks after injury.
- Often due to complications like sepsis or multiple organ failure.

Triage

Triage involves sorting victims based on injury severity, survival likelihood, and urgency of care, particularly in mass-casualty scenarios.
Triage categorizes patients using color-coded tags:
- Red (Immediate): Most critically injured, requiring urgent care (e.g., major head injuries, thoracic or abdominal injuries).
- Yellow (Delayed): Critically injured but stable, requiring hospital treatment.
- Green (Ambulatory): No life-threatening injuries, can walk.
- Black (Expectant): Dead or in a moribund state.

Primary, Secondary, and Tertiary Survey

Primary Survey: Focuses on identifying and treating life-threatening injuries using the 'ABCDE' mnemonic.
- A: Airway maintenance with cervical spine protection.
- B: Breathing assessment and support.
- C: Circulation evaluation and hemorrhage control.
- D: Disability assessment (brief neurological examination).
- E: Exposure/environmental control.
Secondary Survey: Involves a systematic head-to-toe assessment for injuries.
- Includes a thorough inspection of abdominal, pelvic, and thoracic areas, as well as neurological evaluation.
- Patients are asked for an AMPLE history:
  - A: Allergies.
  - M: Medications.
  - P: Past illnesses or pregnancies.
  - L: Last meal.
  - E: Events related to the injury.
Tertiary Survey: Comprehensive evaluation after initial resuscitation, usually about 24 hours post-admission.
- Includes physical examination and targeted radiographic imaging (like X-rays or CT scans) based on initial findings.
- Aims to reduce delays in diagnosing life-threatening injuries.

Description

This quiz covers the Trimodal Mortality Model, detailing early, immediate, and late death in trauma patients. It also explains the principles of triage in mass-casualty situations, including the use of color-coded tags for patient categorization. Test your knowledge on these critical concepts in trauma care.