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Topography of trauma : fissures, disruptions and transfigurations
This volume addresses trauma not only from a theoretical, descriptive and therapeutic perspective, but also through the survivor as narrator, meaning maker, and presenter. By conceptualising different outlooks on trauma, exploring transfigurations in writing and art, and engaging trauma through scriptotherapy, dharma art, autoethnography, photovoice and choreography, the interdisciplinary dialogue highlights the need for rethinking and re-examining trauma, as classical treatments geared towards healing do not recognise the potential for transfiguration inherent in the trauma itself. The investigation of the fissures, disruptions and shifts after punctual traumatic events or prolonged exposure to verbal and physical abuse, illness, war, captivity, incarceration, and chemical exposure, amongst others, leads to a new understanding of the transformed self and empowering post-traumatic developments. 0Contributors are Peter Bray, Francesca Brencio, Mark Callaghan, M. Candace Christensen, Diedra L. Clay, Leanne Dodd, Marie France Forcier, Gen'ichiro Itakura, Jacqueline Linder, Elwin Susan John, Kori D. Novak, Cassie Pedersen, Danielle Schaub, Nicholas Quin Serenati, Asli Tekinay, Tony M. Vinci and Claudio Zanini.
Book
3006 Introduction of a new silver trauma triage tool in a Scottish trauma unit
Aims and ObjectivesThe TARN report ‘Major Trauma in Older People’ found that older trauma are under-triaged, have fewer senior reviews and wait longer for imaging. Normal ageing physiology means that traditional trauma parameters may not trigger, resulting in underestimation of injury severity. We implemented a new Silver Trauma Triage Tool (STTT) to prompt clinicians to consider serious injuries in older patients with low-energy trauma. Having presented an initial audit the Scottish Emergency Medicine Conference 2024 we now report a post-implementation analysis.Method and DesignThe STTT was designed to include all injured patients ≥ 65. Mechanism and physiological parameters were included along with specific anatomical injury triggers. The tool was designed to prompt early senior clinician discussions to determine placement and imaging.The STTT was trialled across a 1-week period in December 2023 and implemented in April 2024. An early post-implementation analysis was conducted in May 2024 to evaluate tool usage, placement outcome and senior reviews, as well as times from arrival to assessment, analgesia and imaging.Results and Conclusion84 eligible patients were identified. The tool was used in 51 patients (61%), an improvement from 32.7% when in the previous audit. 37 of 51 (72%) patients with STTT had a senior input at triage compared with 2 of 33 (6%) when the tool was not used. The STTT changed placement of 5 patients (2 were moved to resus and 3 up-triaged to next to be seen).There was no significant difference in times to assessment, analgesia or imaging, however these measures are confounded by multiple factors that will require a larger dataset to control for. We conclude that the introduction of a new trauma triage tool is feasible and can improve process measures. We hope to report outcome measures in a future analysis of a larger dataset.
Journal Article
Coping with Blast-Related Traumatic Brain Injury in Returning Troops
It has been shown that those who have served in both combat missions and peacekeeping operations are at increased risk for Traumatic Brain Injury (TBI). Research suggests that this may result from their \"wounds of war\". Some wounds may be \"invisible\", such as depression, stress, and chronic pain, while others, such as physical disabilities, are more obvious. In February 2011, 35 scientists and representatives from NATO and Partner countries met in Vienna, Austria for a three-day NATO Advanced Research Workshop entitled \"Wounds of War: Coping with Blast-Related Traumatic Brain Injury in Returning Troops\". The aim of this publication, which presents papers from that workshop, is to critically assess the existing knowledge and to identify directions for future actions. The book addresses four key questions:1. Characterization of TBI: Which characteristics make up and help to classify TBI?2. Diagnosis and Assessment Issues Surrounding TBI: Which methods are used to diagnose and assess TBI? 3. Treatment of TBI: What are the latest treatment and therapy opportunities for soldiers after they have been diagnosed with TBI? 4. Quality of Life: How are the lives of TBI patients affected and in what ways can their quality of life be increased?.
eBook
Trauma Culture
It may be said that every trauma is two traumas or ten thousand-depending on the number of people involved. How one experiences and reacts to an event is unique and depends largely on one's direct or indirect positioning, personal psychic history, and individual memories. But equally important to the experience of trauma are the broader political and cultural contexts within which a catastrophe takes place and how it is \"managed\" by institutional forces, including the media.In Trauma Culture, E. Ann Kaplan explores the relationship between the impact of trauma on individuals and on entire cultures and nations. Arguing that humans possess a compelling need to draw meaning from personal experience and to communicate what happens to others, she examines the artistic, literary, and cinematic forms that are often used to bridge the individual and collective experience. A number of case studies, including Sigmund Freud's Moses and Monotheism, Marguerite Duras' La Douleur, Sarah Kofman's Rue Ordener, Rue Labat, Alfred Hitchcock's Spellbound, and Tracey Moffatt's Night Cries, reveal how empathy can be fostered without the sensationalistic element that typifies the media.From World War II to 9/11, this passionate study eloquently navigates the contentious debates surrounding trauma theory and persuasively advocates the responsible sharing and translating of catastrophe.
eBook
What happened? : re-presenting traumas, uncovering recoveries : processing individual and collective trauma
Traumatic experiences with an overwhelming life-threatening feel affect numerous people's lives. Death and disablement through accident, illness, war, family violence, natural and human-induced disaster can be experienced variously at an individual level through to whole communities and nations. Traumatic memories are intrusive and insistent but fragmented and distorted by the power of sensory information frozen in time. This volume examines the ways individuals, families, communities and nations have engaged with representations of traumas and the ethical dimensions embedded in those re-presentations. Contributors also explore the work of recovering from trauma and finding resilience through working with narrative and embodied forms such as dance and breathing. The ubiquity of trauma in human experience means that pathways to recovery differ, emerging from the way each engages with the world. Sharing, and reflecting on, the ways each copes with trauma contributes to its understanding as well as pathways to recovery and new strengths. Contributors are Svetlana Antropova, Peter Bray, Kate Burton, Mark Callaghan, Marie France Forcier, Monica Hinton, Gen'ichiro Itakura, Danielle Schaub, Zeina Tarraf and Paul Vivian.
Book
Management of severe trauma worldwide: implementation of trauma systems in emerging countries: China, Russia and South Africa
As emerging countries, China, Russia, and South Africa are establishing and/or improving their trauma systems. China has recently established a trauma system named “the Chinese Regional Trauma Care System” and covered over 200 million populations. It includes paramedic-staffed pre-hospital care, in-hospital care in certified trauma centers, trauma registry, quality assurance, continuous improvement and ongoing coverage of the entire Chinese territory. The Russian trauma system was formed in the first decade of the twenty-first century. Pre-hospital care is region-based, with a regional coordination center that determines which team will go to the scene and the nearest hospital where the victim should be transported. Physician-staffed ambulances are organized according to three levels of trauma severity corresponding to three levels of trauma centers where in-hospital care is managed by a trauma team. No national trauma registry exists in Russia. Improvements to the Russian trauma system have been scheduled. There is no unified trauma system in South Africa, and trauma care is organized by public and private emergency medical service in each province. During the pre-hospital care, paramedics provide basic or advanced life support services and transport the patients to the nearest hospital because of the limited number of trauma centers. In-hospital care is inclusive with a limited number of accredited trauma centers. In-hospital care is managed by emergency medicine with multidisciplinary care by the various specialties. There is no national trauma registry in South Africa. The South African trauma system is facing multiple challenges. An increase in financial support, training for primary emergency trauma care, and coordination of private sector, need to be planned.
Journal Article