SU17.1-10 | Trauma — Glossary

A superficial open wound involving only the epidermis and superficial dermis, from scraping across a rough surface.

Occasional slow, gasping, ineffective breaths after cardiac arrest; a sign of arrest, not of life — it must trigger CPR.

The structured trauma assessment — Airway, Breathing, Circulation, Disability, Exposure — in which the life-threatening chest injuries are found and treated as they are identified.

A portable device that analyses the cardiac rhythm and delivers a shock only for shockable rhythms (VF/pulseless VT).

An injury that tears a flap of tissue partly or completely free from its base.

The maintenance of airway, breathing and circulation by chest compressions, rescue breaths and an AED, without advanced equipment.

The signs of cardiac tamponade — muffled (distant) heart sounds, raised JVP/distended neck veins, and hypotension.

A casualty with no signs of life or injuries incompatible with survival given resources; receives comfort care only.

The modern adult BLS order — Circulation (compressions) first, then Airway and Breathing — to avoid delaying compressions.

The time for colour to return after blanching a nail bed; longer than 2 seconds indicates poor perfusion in START.

Blood in the pericardium compressing the heart and preventing diastolic filling, reducing cardiac output.

Rhythmic compressions over the lower half of the sternum at 100-120/min and 5-6 cm depth that maintain circulation during cardiac arrest.

The safe area containing the casualty treatment and transport sites.

A Glasgow Coma Scale of 8 or less, defining severe head injury and the threshold for securing the airway by intubation.

The adult cycle of 30 chest compressions to 2 rescue breaths.

A closed injury with bleeding into intact tissues from blunt force.

The emergency surgical removal of a compressing intracranial haematoma — life-saving and time-critical for an extradural or large acute subdural bleed.

The triad of hypertension, bradycardia and irregular respiration signalling dangerously raised intracranial pressure — a late, ominous sign.

Removal of foreign material and excision of devitalised (dead) tissue from a wound to prevent infection.

Removal of part of the skull to relieve refractory brain swelling and raised intracranial pressure.

Shearing that strips skin and subcutaneous tissue off the underlying fascia.

Cleaning a contaminated wound now and closing it after a few days once it is clean.

Widespread shearing of axons from rotational forces at impact, a major cause of coma and poor outcome.

The first-aid primary-survey sequence: Danger, Response, Shout for help, Airway, Breathing, Circulation.

An arterial bleed (usually middle meningeal artery) between skull and dura, biconvex on CT, classically with a lucid interval.

The immediate assistance given to a sick or injured person before professional medical help arrives.

The trained person who delivers immediate assistance at the scene before EMS arrival.

A free chest-wall segment from fracture of two or more adjacent ribs each in two or more places, moving paradoxically; the main danger is the underlying pulmonary contusion.

A standardised score of consciousness from Eye (max 4), Verbal (max 5) and Motor (max 6) responses; total 15 (minimum 3).

The early period after major injury during which prompt, correct treatment most improves survival.

The governing principle of disaster care — directing scarce resources to those most likely to survive with timely treatment.

The walking wounded with minor injuries; lowest treatment priority.

A localised collection of blood within tissue following injury.

A stony-dull percussion note over a haemothorax (blood), in contrast to the hyper-resonant note of a pneumothorax (air).

A pre-prepared hospital protocol that expands capacity in a disaster by recalling staff, clearing beds/theatres, mobilising blood and opening a triage point and command post.

The dangerous area of the incident itself, entered only by trained, protected rescuers.

Passive antibody given (with toxoid) for a tetanus-prone wound in an incompletely immunised patient.

The single coordinating authority that takes scene overview, calls for help and assigns roles in a disaster response.

A clean-edged wound from a sharp object, with smooth well-apposed margins and no tissue bridges.

A tube inserted into the pleural space, connected to an underwater seal, to drain air or blood and re-expand the lung.

The pressure inside the skull; a sustained rise reduces cerebral perfusion and causes ischaemia and herniation.

A wound from blunt force tearing the skin, with irregular ragged edges and intact tissue bridges.

A coordinated turn of a patient as a single rigid unit, with one rescuer controlling the head, to protect the spine.

A transient recovery of consciousness after head injury before deterioration, classic of an expanding extradural haematoma.

An osmotic diuretic used to reduce raised intracranial pressure in a deteriorating head-injured patient.

Holding the head and neck steady in neutral alignment by hand to protect a possibly injured cervical spine during movement.

An event producing casualties in numbers that overwhelm the staff, equipment and facilities available to treat them.

Rapid bleeding into the pleural space causing lung compression and shock; >1500 mL drained initially or >200 mL/h indicates thoracotomy.

The artery running between skull and dura, torn in temporal fractures to cause an extradural haematoma.

The principle that the volumes of brain, blood and CSF in the rigid skull are fixed, so an added mass eventually raises intracranial pressure.

Emergency insertion of a wide-bore cannula into the pleural space to release a tension pneumothorax, always followed by a definitive chest drain.

The first-line investigation in head injury, rapidly showing haematomas, fractures, contusions and swelling.

A chest-wall defect through which air moves in and out of the pleural space, impairing ventilation; treated initially with a three-sided dressing.

Inward movement of a flail segment on inspiration and outward on expiration, opposite to the normal chest wall.

The potential space between the lung and chest wall; its negative pressure keeps the lung expanded, so air or blood entering it collapses the lung.

Damage inflicted at the instant of impact (contusion, laceration, diffuse axonal injury); largely irreversible.

Immediate suturing of a clean, recent wound with viable, well-apposed edges.

Bruising of lung tissue after blunt chest trauma causing hypoxia; the chief danger underlying a flail chest.

A deep, narrow wound from a pointed object that carries contamination deep and favours anaerobic infection.

Repeating triage as a casualty's condition evolves or resources change, since triage is dynamic rather than a single verdict.

A stable side-lying position for an unresponsive but normally breathing casualty (no spinal concern) that keeps the airway open and lets secretions drain.

A life-threatening but salvageable casualty requiring immediate treatment and first-priority transport.

The resumption of an effective heartbeat, shown by movement, coughing, eye-opening or normal breathing.

Rest, Ice, Compression and Elevation — first-line treatment of closed soft-tissue injuries such as sprains and contusions.

The three START parameters — Respiration, Perfusion, Mental status — used to triage each non-walking casualty.

The recommended site for chest-drain insertion (around the 5th intercostal space, anterior to the mid-axillary line) bordered by pectoralis major and latissimus dorsi, chosen to avoid vital structures.

Confirming the area is safe for rescuer, casualty and bystanders before approaching — the overriding first action.

Further brain damage developing after impact from hypoxia, hypotension, raised ICP, ischaemia, seizures and fever — preventable by good management.

Leaving a wound open to heal by granulation, or grafting it later, when primary closure is unsafe.

Ventricular fibrillation or pulseless ventricular tachycardia — the rhythms an AED/defibrillator can treat with a shock.

Injury to skin, subcutaneous tissue, muscle, tendon, ligament, nerve or vessel, with or without a break in the skin.

Immobilising a fractured limb (joint above and below) to reduce pain, bleeding and further injury before transport, with distal circulation and sensation checked.

Stretching or tearing of a ligament from a closed injury.

Simple Triage And Rapid Treatment — the most widely used adult field triage algorithm, sorting casualties in under a minute.

Stretching or tearing of a muscle or its tendon.

A venous bleed from torn bridging veins between brain and dura, crescentic on CT; common in the elderly and anticoagulated; acute or chronic.

Air trapped under rising pressure in the pleural space by a one-way valve, collapsing the lung and shifting the mediastinum to impair venous return — a clinical diagnosis needing immediate decompression.

A wound at risk of tetanus — contaminated with soil/faeces, devitalised, deep puncture, delayed over 6 hours, a bite or a burn.

Injury to the chest wall, lungs, heart or great vessels, impairing oxygenation, ventilation and/or circulation.

Surgical opening of the chest, indicated in chest trauma for massive or ongoing haemothorax and for some cardiac and great-vessel injuries.

A dressing taped on three sides over a sucking chest wound that lets air escape on expiration but not enter on inspiration, preventing a tension pneumothorax.

The rapid sorting of casualties by clinical priority and likelihood of benefit when resources are limited; dynamic and repeated.

Displacement of the temporal lobe compressing the third nerve and brainstem, producing a fixed dilated pupil, usually on the side of the clot.

Casualties able to walk on command; cleared to a designated area as GREEN at the first step of START.

The area where casualties are gathered and triaged, between the hot and cold zones.

A casualty with serious injuries who can safely wait a short time for treatment and transport.