How to turn panic into action: trauma care during the golden hour

Dr. Paromita Kanjilal Chakraborty is a Consultant in Emergency Medicine with over 8 years of experience. Holding an MBBS, DNB in Family Medicine, and MEM, she is skilled in acute care, trauma care, and emergency medical services. Dr. Chakraborty has also served as a consultant at Peerless Hospital. She is a member of the Indian Medical Association and a member of the Society of Emergency Medicine India and the American Association of Family Physicians.

Injuries from road traffic accidents (RTAs) and household emergencies are significant causes of trauma worldwide. According to the Home Accident Statistics 2024 by the National Safety Council (NSC), 38.6 deaths per 100,000 population occurred in 2021 due to home injury-related reasons. As much as 76% of all avoidable injury-related deaths occur inside our homes. The World Health Organization states that 1.3 million deaths result annually from road accidents, a whopping 93 percent of which take place in developing nations. Such incidents lead to tragic loss of life but also impose considerable economic burdens on individuals, families, and communities. The most vulnerable victims of these accidents are motorcyclists who comprise 34 percent of all traffic deaths. Most, victims are not administered proper medical treatment and first aid on time.

Our homes often appear to be the most secure place. Nevertheless, apart from vehicular accidents, and industrial accidents, it is also a most common place for trauma within our households through burns, electrocution, falls, and injury from sharp objects. This article offers an overview of common trauma-related injuries- both at home and on the road.

Responding to Road Traffic Accidents

When witnessing a road traffic accident, the priority is ensuring scene safety. Before approaching any victim, take a moment to assess the environment. Look for hazards such as oncoming traffic, potential fires, or additional collisions that could pose risks to you and the victims. Once it is safe, carefully extricate the victim from the vehicle maintaining spinal immobilization as much as possible, and then move them to a secure area away from further danger.

After relocating, place the victim on a hard and flat surface, i.e. pavement, road, or floor to prevent neck and head movement as much as possible, and call for immediate help or an ambulance. Quickly assess their pulse and breathing within about ten seconds. If responsive, monitor for signs of deterioration, such as loss of consciousness, seizures, or abnormal breathing patterns, ensuring you do not disturb any potential spinal injuries. In case the victim is unresponsive and there is an absence of pulse and breathing, initiate chest compression. India's Good Samaritan Law was passed as a Bill by the Supreme Court of India on March 30, 2016. This law protects those who help an accident victim from legal interventions, encouraging more people to offer help without fear.

Suspected fracture, deformed limb

In case, the victim has a visibly deformed limb or a bone piece sticking out of the wound, do not try to put it back into the wound. It is advisable to wrap the wound with a clean piece of cloth. You can support the limb with a pillow or a rolled towel. Apply ice on the injured area, avoid placing ice on open wounds. Trauma from accidents often occurs in industrial settings. If a foreign body such as an iron rod, penetrates a wound, do not try to move the foreign body. For easy transport, the iron rod can be shortened with a drilling machine.

Burns

In case of any burn, run cool (not cold) water over the affected area for 10 to 20 minutes, to help alleviate pain and limit damage. Do not remove any cloth sticking to the wound.  After cooling the burn, gently cover it with a clean, wet cloth. Avoid breaking any blisters, as this increases the risk of infection.

It is important to note burn injuries are notorious for infection, such as increased redness, swelling, or pus. If any of these symptoms occur, seek medical attention promptly. The victim may need a tetanus prophylaxis shot. In case of a chemical burn, wash the area liberally with copious amounts of water. For any burn wound seek medical assistance.

Fire can lead to carbon monoxide poisoning if the room catches fire with doors and windows closed. It is important to stop the fire and ventilate the place. Try not to inhale the smoke. If you suspect someone is suffering from carbon monoxide poisoning, quickly move the affected person to fresh air and seek medical help. Avoid giving the victim anything to eat or drink if they are unresponsive.

Severed Finger

A severed finger is a serious injury that requires immediate attention. If someone has experienced this type of trauma, follow these steps:

Control the Bleeding: Apply direct pressure to the wound using a clean cloth or bandage. Elevate the injured hand to reduce further bleeding.

Preserve the Severed Finger: In case you see the amputated part, rinse it gently with clean water to remove any dirt. Wrap the finger in a clean, damp cloth or sterile gauze, and place it in a sealed plastic bag. Keep this bag on ice, but do not place the severed part directly on ice or water, as extreme cold can damage the tissue.

Seek Medical Help Immediately: Call for an ambulance and reach the nearest hospital as soon as possible. Inform the medical staff about the severed finger and first aid measures taken beforehand.

Chemical consumption

In case of any chemical consumption, immediate action is crucial. Dial emergency services or take the victim to the nearest hospital immediately. Provide as much information as possible about the substance consumed. If possible, collect samples of the fruit or substance involved for identification at the hospital. Avoid giving food or even water to the victim. Do not try to induce forced vomiting.

Snakebite

Firstly, do not panic. Keep the affected limb immobilized. Click a picture of the snake while maintaining safety. As swelling may occur, it is important to remove any constrictive items near the bite site. Do not try to suck out the venom as this is ineffective and can cause more harm than good. Do not apply ice as this can damage the tissue. It is crucial to remember not to apply a tourniquet. Tourniquets can restrict blood flow and may lead to loss of the limb. Anti-venom is usually available at all health centers and hospitals, and immediately rush for assistance.