الفهرس 
Initial Assessment and Management of TraumaticOnly 14 pages are availabe for public view
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Abstract
Trauma is a senous threat in developing countries. Preventive efforts, which have been so effective
in other countries in controlling the incidence of injuries, are almost and tribal cultures may
practice rituals that create personal injury. Developing nations lack adequate health care services
for a large section of the population (Ruffolo, 1997).
Traumatic injury has been termed the ”neglected disease of modern society” and is viewed as the
epidemic of the 1990s. Traumatic injury accounts for over 140,000 deaths per year in the United
States, and one person in three suffers a non-fatal injury. Additionally, for every death, another
two persons are permanently disabled. Trauma is the leading cause of death for individuals up to
44 years of age. It is the fourth overall cause of death for all individuals, exceeded only by
cardiovascular disease, cancer, and stroke. Trauma affects predominantly young individuals, with
its peak incidence in the 15 to 24 per year old age group. It is the leading killer of children.
The majority of patients die either at the accident scene or in the first several hours after
injury. The third peak of deaths occurs days to weeks later when the patients succumb to sepsis or
multiorgan failure. Acknowledgeable critical care nurse functions as part of the trauma team in
her efforts to decrease death and morbidity during this period (Hoyt ami Fridlund, 1996).
In Egypt, advances made in the control of diarrheal disease, in vaccination against measles, polio,
and diphtheria, in maternal and child health services, and in family planning, threaten to be
erased by increasing numbers of fatal and disabling injuries. In Egypt, about one in every five
children ”those who have survived the potential threat of infectious disease during their first
years of life” dies from injuries before age of five. More Egyptians die on roads than from
tuberculosis, whooping cough, meningitis, and/or measles combined (Youssef, 1993).
At the present time, the incidence and importance of the different killers of man are changing.
Injuries are increasing and rank near the top of the list. This change is not restricted to the
developed world, but has also occurred in the developing world through the failure to recognize the
problem of injury on the public’s health, by failure to take safety precautions, and through the
usc of obsolete, dangerous equipment (Elias, 1993).
In 1987, injuries were the fifth leading cause of death in both males and females, accounting for
4.1% of all deaths. The top four causes of death were cardiovascular disease (33.1%), respiratory
disease (14.8%), infectious I parasitic diseases (10.4%) and diseases of the digestive system
(4.8%). There were 8,919 unintentional injury deaths ”accidents and adverse effects” reported by
cause to the Central Agency for Population, Mobilization. And Statistics (CAPMAS). The leading
causes of mJunes were fatalities associated with motor vehicle traffic injuries (3,248),
Poisonings (1,340), and fatal falls (580). There
were 241 homicides and 22 suicides. Slightly more than 25% of these fatal injuries were reported as
”other injuries”. In addition to the 8,919 injmy deaths reported by cause, 10,013 deaths were
reported as caused by ”other violence” these deaths were not reported in sufficient detail to
determine the cause of death. Distribution of these ”other violence” injuries by age group, gender,
and Governorate is not known. In this report, ”other violence” deaths have been combined with
deaths reported from known causes a uniform distribution by causes, age group, gender, and
Governorate has been assumed (El-Sayed, 1993).
Trauma is the leading cause of deaths in any country for people in the first four decades of life
(Newberry, 1998).
Incidence is not limited to densely populated areas but occurs in all geographic regions of the
countJy. Trauma care is ideally provided in institutions that specialize in trauma; however, trauma
centers are not as widely distributed as the patients who require care. Most trauma patients are
assessed, stabilized, admitted, or transferred by emergency departments (ED) in non-trauma centers
(Weigelt, 1993).
Emergency nurses in these facilities are challenged by trauma situations similar to those seen in
designated trauma centers. Meanwhile trauma centers have treatment areas, staff, and physicians
dedicated to assessment, stabilization, and long term care of injured patients (Rotz, 1994).
Injury and the mortality, morbidity and disability caused by injuries is an emerging health
problem in the developing