Global trends in trauma

Abstract

Injuries cause about 10% of all deaths worldwide, with road traffic accidents, selfinflicted injuries, violence and war injuries being the most common causes of traumatic deaths. There is an anticipated increase in all of these categories by the year 2020. In addition to the increasing global incidence of trauma, other major trends in trauma and its management identified in this review include the growing emphasis on prevention and public health aspects of trauma, the globalization of trauma practices due to the rapid access to new information, a critical emphasis on organizational aspects of trauma care and education, the prominent role of efficacious and cost effective management practises, a shift to gentler treatment methods with less interference in the physiological recovery mechanisms, and at the same time, extreme care and the management of its consequences. In order to fight the global epidemic of trauma, it is the duty and the privilege of health care professionals to take the leadership in this task by 'thinking globally and acting locally ' but most importantly by working together and sharing their experiences (the successes and the failures) and by knowing that they can make a difference.

The more things change, the more they stay the same

“…Five years later, these global trends in trauma were re-examined, and Leppaaniemi reiterated many of the findings of the earlier paper and also predicted from where future conflicts may emanate 3 : One sees the communal conflicts between states and groups from different civilizations (Western, Orthodox, Islamic, Hindu, Sinic, Japanese, African, Latin American) as a major factor leading to future conflicts based on fundamental differences in society and culture, especially between ‘the West and the Rest’ is a prediction that readers will recognise but his other prediction emphasised the importance of the possession of vital materials as the main source of future conflicts with the ‘ the most contested resources and areas would be oil and gas (Persian Gulf, Caspian Sea, South China Sea), water (Nile, Jordan, Euphrates and Indus River Basins), minerals, gems and timber. ’ To date, natural resources conflicts are sporadic and generally low key.…”

“…The special services provided by surgical subspecialists would be provided on a less urgent basis the following day, or for the rare urgent emergencies on an on-call basis. 3 This proposal echoes the plans currently arising from organisations such as the Association of Surgeons of Great Britain and Ireland and the Royal College of Surgeons as NHS Trusts struggle with how to provide emergency surgical services, so it is fascinating to realise that it was actually presented at America's Eastern Society for the Surgery of Trauma in Florida in 2004 and again highlights what seems to be a 10-year lag in UK trauma services.…”

“…The special services provided by surgical subspecialists would be provided on a less urgent basis the following day, or for the rare urgent emergencies on an on-call basis. 3…”

“…Science is awash with great ideas that never quite made it and trauma surgery is no exception as ‘ another interesting development in the management of exsanguinating haemorrhage involves the potential use of recombinant activated factor VII (rFVIIa) in trauma surgery ’, 3 which has fallen at the hurdle of randomised controlled trial data (the CONTROL trial).…”

Index for Volumes 1—11

“…Bewes, P. 1999;1: 341-350 Global trends in trauma. Leppa¨niemi, A.K. 2004;6: 193-203 Update on global trends in trauma.…”