Multiple trauma, shock and coma

The aim of this topic is to review the pathophysiology of multiple trauma, with particular reference to shock, coma and the complications of fractures.

Learning objectives:

At the completion of this topic you should be able to:

  1. List the likely causes of death following trauma to the head, thorax and abdomen.
  2. Describe the pathophysiology of coma following intracranial haemorrhage.
  3. Compare and contrast extradural haematoma with subdural haematoma.
  4. Outline the Glasgow Coma Scale and explain its importance.
  5. Describe the pathophysiology of tension pneumothorax following trauma.
  6. Discuss the pathophysiology and clinical effects of ruptured or lacerated abdominal viscera, in particular the liver and spleen.
  7. Outline the local and systemic complications (both immediate and delayed) of a compound fracture of the femur.
  8. Discuss the process by which fractures heal and the circumstances that might impair healing with particular reference to osteomyelitis.
  9. Outline the pathophysiology of acute renal failure and adult respiratory distress following severe trauma.

Trial exam questions:

  1. Group the causes of acute renal failure (ARF) into pre-renal, intra-renal and post-renal. How could you distinguish clinically between pre-renal and intra-renal ARF?
  2. Describe the causes and pathophysiology of the adult respiratory distress syndrome (ARDS).

Case protocol associated with this topic - 25

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