Hyderabad: When a person suffers a serious road crash, fall or other traumatic injury, survival can depend not only on the severity of the injury but also on what happens in the first few minutes and hours.

How trauma care is different from other medical treatments

This makes trauma care different from many other forms of medical treatment.

It is a time-sensitive, multidisciplinary process that begins at the scene of an accident and can continue through ambulance transport, emergency care, surgery and critical care.

The issue came into focus at a Continuing Medical Education programme on trauma care held at Osmania General Hospital in Hyderabad on Saturday, August 29, where doctors, postgraduate students, nurses and paramedics discussed the need for a more structured approach to treating trauma patients.

Why the first few minutes matter

Trauma patients can have multiple injuries at the same time. A person involved in a road crash, for instance, may have a head injury, internal bleeding, airway obstruction or fractures that are not immediately visible.

The World Health Organisation says injuries cause around 4.4 million deaths globally every year and account for about 10 per cent of all years lived with disability. People who are critically injured need timely, quality care wherever they enter the health system.

Golden hour in trauma care

India’s Health Ministry also emphasised the importance of the ‘golden hour’ in trauma care, with its national trauma-care programme designed to reduce preventable deaths by strengthening trauma facilities and referral networks.

What happens during a trauma assessment?

A systematic trauma response begins with a primary survey, where doctors rapidly look for immediately life-threatening problems.

This broadly involves checking the patient’s airway, breathing and circulation, while also assessing neurological status and looking for serious external injuries. Once immediate threats are addressed, a secondary survey is conducted to identify other injuries that may not have been apparent during the initial assessment.

The distinction is important because trauma care is not simply about treating the most obvious injury.

A patient with a visible fracture may also have internal bleeding or a head injury requiring urgent intervention.

The WHO recommends a structured approach to trauma assessment and has developed a Trauma Care Checklist to help emergency teams ensure that critical, lifesaving steps are not missed.

Trauma care does not begin at the hospital

The chain of care begins before the patient reaches an emergency department.

The WHO describes injury care as an integrated process involving community first aid, care during transport, emergency and critical care, surgery and rehabilitation.

That makes pre-hospital care particularly important.

An injured person may lose valuable time if an ambulance is delayed, if the patient is taken to an inappropriate facility or if crucial information is not communicated during transfer.

India’s Health Ministry similarly describes pre-hospital care as the earliest link between the scene of an emergency and trained healthcare providers, noting its importance in making the ‘platinum minutes’ and golden hour effective.

Why trauma care needs many specialists

A serious trauma case rarely belongs to a single department.

Emergency physicians may lead the initial assessment, while anaesthesiologists may manage the airway and resuscitation. Trauma surgeons, orthopaedic surgeons, neurosurgeons, critical-care specialists, ophthalmologists and nurses may become involved depending on the injuries.

The CME at Osmania General Hospital brought together professionals from several of these disciplines, with sessions covering damage-control resuscitation, surgery, airway management, pelvic trauma and ocular injuries.

Dr GV Ramana Rao, Medical Director of EMRI and Vice President of ITC Hyderabad Chapter, said strengthening trauma care requires seamless coordination between bystanders, emergency medical services, hospitals and specialist teams.

The role of bystanders

Professional medical care may take time to reach an accident scene, making the actions of bystanders important.

Experts at the CME highlighted the role of Rah-Veers or Good Samaritans, encouraging citizens to assist trauma victims until professional help arrives.

The WHO similarly recognises early community response as part of the trauma-care chain and has developed training approaches for non-health professionals to recognise emergencies and provide initial assistance.

The aim is not to turn bystanders into doctors, but to ensure that potentially life-saving assistance is not delayed while waiting for an ambulance.

Building a trauma-care system

The Ministry of Health and Family Welfare says more than 10 per cent of deaths in India can be attributed to injuries, with road traffic injuries, drowning, burns and falls accounting for a substantial share.

Its National Programme for Prevention and Management of Trauma and Burn Injuries has supported trauma-care facilities and capacity-building for healthcare personnel.

The Hyderabad CME is now being followed by plans from the International Trauma Care–Hyderabad Chapter to conduct Comprehensive Trauma Life Support courses across medical colleges and healthcare institutions in Telangana.

The larger challenge is to ensure that trauma care functions not as a series of disconnected interventions, but as one coordinated system, from the accident scene to the emergency room, operating theatre and intensive care unit.