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Trauma: Emergency Resuscitation, Perioperative Anesthesia, and Surgical Management, Volume I
Trauma: Critical Care, Volume II

Hasan B. Alam, MD, Reviewer; Marc de Moya, MD, Reviewer
JAMA. 2008;299(5):577-578. doi:10.1001/jama.299.5.577.
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Very few things alter human lives like major injuries. Whether injuries result from a large-scale natural disaster, terrorist attack, military conflict, violent crime, or motor vehicle crash, the impact for the injured and their loved ones is profound, abrupt, and lifelong. Beyond the individual human effects, there is the enormous societal cost. One needs only to appreciate that traumatic injuries are the primary cause of death and disability among persons younger than 44 years and that more persons in the United States between the ages of 1 and 34 years are killed by such injuries than by all other diseases combined. The 50 million injuries that required medical treatment in 2000 will ultimately cost US society $406 billion, according to the US Centers for Disease Control and Prevention. Worldwide, injuries kill more than 5 million people and cause harm to millions more every year.

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Figure. Emergency department physicians are trained in the treatment of various injuries. Left, Machine injury resulting in significant damage to the right upper extremity. Despite efforts at limb salvage, the patient eventually underwent an above-the-elbow amputation. Right, Type III open tibula-fibula injury following a motorcycle crash. Subsequent triage and treatment involved muscle flap transfer and external fixation of the fracture site. Photographs taken from “Trauma Series,” courtesy of P. Christensen.



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