Trauma vs. ER

[healthstar, BSN, RN]

Good morning,good afternoon, good evening,

Excuse my ignorance. Can someone tell me the difference between trauma and ER--how are they different, what goes on in trauma and ER? When we have serious health problems we go straight to ER, some get trasferred to trauma department right away. I am wondering why.( I hope no one gets offended by this, I am not saying they are the same)

Thank you :)

[happy2learn]

Trauma is a section of the ER I volunteer at (also a Level 1 Trauma center). Trauma is more severe than being in the ER, from what I understand.

I mean, most of the people in the ER are awake and can talk, they seem okay for the most part (from what can be seen.)

But the patients in trauma are beyond ill. Most of the patients that end up in trauma where I am at are severe car accidents, gun shots, stabbings... just brutal injuries.

Like I said, I'm just a volunteer. I'm not a nurse yet so I couldn't tell you from a nurse's point of view, just someone who sees it and has to inform families.

[BrnEyedGirl, BSN, MSN, RN, APRN]

The ER where I work is a Trauma Center. We have specialized training, staff and equipment to take care of Trauma Pt's. We have specific rooms in the ER that are designed for Trauma Pt's. As a pt you probably wouldn't notice the difference between our "ER" and the "Trauma" rooms. There is certain criteria that must be met in order to be designated a Trauma Center,.for instance we have Trauma surgeons in the building 24/7, surgery staff 24/7, a certain number of ICU beds available, participate in research.....if you google Level I Trauma centers you'll get lots of info.

[Finallydidit]

One way to look at it is TRAUMA = Blood and guts.. So think of wounds, and injuries as opposed to illness and sickness

[foreverLaur]

Normal ER visits are those that bring themselves in. Trauma patients are the ones coming in via 911 calls, ambulances, helicopters, etc. General rule of thumb - they are obvious exceptions as stabbings & gunshot wounds do happen outside of hospitals or the victims come wandering in.

Another way to look at it is if you are a regular ER patient, you wait in the waiting room and wait to see the nurse and wait to see the doctor, etc. Trauma patients are being attended to instantly and around the clock.

[murphyle, BSN, RN]

From the Trauma Nursing Core Course Provider Manual, 6th Edition:

Trauma is any injury to the body caused by transfer of energy from the outside environment, such that the energy transferred into the body exceeds the body's ability to absorb said energy. That energy can be kinetic energy such as that imparted by acceleration or deceleration (i.e. motor vehicle crashes, pedestrian vs. vehicle incidents, falls, etc), that imparted by a blunt object (beatings, crush injuries, falls onto objects, etc), that imparted by a sharp object (stabbings, impalements, gunshot wounds, etc); it can be thermal energy, such as that imparted by a fire (burns); electrical energy (electrocutions, lightning strikes); chemical energy (burns, accidental or intentional ingestions); or radiant energy (UV burns, ionizing radiation exposures). Drownings and smoke inhalations are instances of trauma in which the mechanism of injury is a lack of energy - specifically oxidative injury resulting from anoxia.

From the emergency healthcare perspective, "trauma" refers to a severe injury or injuries to the body requiring immediate and intensive management. Frequently (though not always!) they present to the care setting via EMS, and their immediate care consists of ensuring airway patency, effective respiratory function, hemodynamic stability and neurological function until definitive care (usually surgical) can be provided.

Not every emergency facility has the staff or the resources to provide that definitive care. There is an accreditation process for trauma centers, overseen by the American College of Surgeons, which divides emergency facilities into Level I (most comprehensive, specialty staff on-site 24/7, also conducts trauma research) through Level III (least comprehensive, basic services available, has agreements with Level I/II centers for trauma transfers). When trauma cases present to low-ranked or unaccredited facilities, the staff there will provide immediate care in preparation for transfer to a higher-ranked facility.

If trauma is something that interests you, I'd recommend going to a medical library and finding a copy of the TNCC manual. It's everything you need to know about trauma nursing in one package.

Hope this helps! :)

[foreverLaur]

Murphyle,

Is there a more recent copy of that text? The most recent one I could find was written 10 years ago and I'm sure a lot in health care has changed in the past 10 years!!

[murphyle, BSN, RN]

foreverLaur: Yes, the most recent (6th Edition) is dated 2007.

[healthstar, BSN, RN]

Thank you everybody, every single post is helpful.

[Sugarcoma, RN]

Just for clarification: To the post that said traumas come in via EMS and ER pts. have to wait in the waiting room: Some ER patients are attended to instantly and arrive via EMS but do not qualify as traumas (trauma=some type of injury). Pt's that have conditions such as MI, CVA, status asthmaticus, DKA, etc. Often times in just as bad or worse condition as the trauma people and need emergent care also.

[WildLPN]

At the Trauma ctr that I work at traumas that come in are based on their glasgow score. Also their acuity level.

Trauma is generally a severe injury.

[weatherck]

I am making a lateral move from a non-trauma to a trauma ER. Any advice on what I should be studying up on before I start orientation.