What Is Blunt Trauma?

Introduction 

Blunt trauma is an injury caused by the forceful impact of a blunt object on the body, which  can be fatal. The type of wound that appears depends on the force of the object, the affected area and the duration of the impact.¹

Serious injuries are usually caused by road accidents, assaults and sports injuries. Blunt trauma is particularly common in the elderly as they are prone to falls. 

Blunt trauma is one of the leading causes of death in those under the age of 35. Ensuring people’s safety before performing any potentially dangerous tasks will reduce the likelihood of accidents. 

Types of blunt trauma injuries

Blunt trauma injuries can be classified into four groups:

Contusion

Most commonly described as a bruise where the affected area on the skin appears purple or green as the capillaries and the veins have ruptured. It usually takes 2 weeks for the bruise to fade but can take longer to heal depending on the extent of the injury.¹

Apply ice packs and elevate the injured area to avoid further complications. 

Abrasion 

Have you ever grazed your skin so that it starts to bleed? This type of injury is called an abrasion where the skin has been chafed against a rough surface.²

It usually takes 2 weeks to heal through scab formation. 

Ensure you protect your skin and avoid picking at the scab as it helps protect the wound while your skin heals.

Laceration

Laceration refers to a blunt or dull object that tears the skin causing irregular patterns to form.

A strong understanding of the skin can guide clinicians in understanding the extent of the injury. 

Wound healing repairs damaged tissue and goes through four overlapping stages including inflammation, tissue formation and tissue remodelling.³

Fracture

Injuries that break, or partially break, bones are referred to as fractures. A bone can fracture in many different ways.

Causes of blunt trauma 

Blunt trauma injuries are typically caused by being involved in serious accidents such as:

• Motor vehicle accidents
• Falls (common in the elderly)
• Sports injuries
• Assaults

Common injuries associated with blunt trauma 

Assessing the type of blunt trauma injury is critical to ensure serious injuries are not missed as they can be fatal. The most common injuries include:

Head injuries

Concussion

A forceful impact on the head results in a temporary loss of normal brain function, known as concussion. The affected individual may experience headaches, dizziness, temporary memory loss, confusion and vomiting. 

Serious symptoms include:

• Black eye
• Difficulty staying awake 
• Unconscious and cannot be woken up
• Problems with balance and speaking
• Seizures

Concussion is usually not a sign of something serious but if someone is experiencing these symptoms you must call your local emergency services quickly. In the UK, call 999. 

Skull fractures 

Skull fractures result in damage to the bones that compose the base of the skull. The bones that encompass the skull are the frontal, parietal, temporal and occipital bones. Together they provide structure and protection for the brain. The temporal bone is typically affected by a blunt object but the frontal lobe may also be involved.⁴

Following a traumatic injury to the head an individual may experience:

• Dizziness
• Headaches
• Bruising around the eyes 
• Feeling sick (nausea) or vomiting

An injury to the head is typically a sign of concern and needs attention by a doctor immediately. Even if the affected individual  appears fine, it is advisable to seek medical assistance for a check up/tests.

Chest injuries

Rib fractures

A blow to the ribs can be very painful. It is not necessary to go for an X-ray or be hospitalised because the structure of the ribs cannot be easily broken, so the doctor will advise the individual to avoid activities that might strain their ribs and to get plenty of rest. 

A rib fracture will take approximately six weeks to heal. 

Lung contusions 

Serious injuries to the lungs require immediate medical attention as they can result in breathing difficulties or even death if not treated. 

When the alveoli (tiny air sacs in the lungs which exchange oxygen and carbon dioxide) and capillaries are damaged, blood and other fluids leak into the lungs and air sacs. This causes problems with breathing and too much carbon dioxide (hypercapnia) and too little oxygen (hypoxaemia) will be present in the blood.⁵

Abdominal injuries

Organ damage

Damage to the organs can result in internal bleeding. Common abdominal injuries include damage to the bowel, spleen, intestines or liver. 

It is difficult to determine the diagnosis but patients may typically present with symptoms such as unstable vital signs ( rapid heart rate and low blood pressure) and bleeding. 

Extremity injuries 

Extremity injuries can be classified into two groups: upper (affecting the arms) and lower (affecting the legs). These injuries include:

• Fractures 
• Sprains
• Dislocations
• Strains

Diagnosis of blunt trauma 

Clinical assessment 

A thorough history and physical assessment of the affected individual are critical to avoid missing an injury. Doctors and nurses will assess the airways, breathing, heart rate, and any disabilities and exposures. 

Imaging studies (X-rays, CT scans) 

If the doctors suspect a serious injury to the area, they will send the individual for tests. X-rays and CT scans will show any broken bones or blood vessel ruptures. 

Blood tests (CBC/FBC, coagulation studies)

Although doctors can visually assess the patient’s condition, blood tests can provide further information. A study found that blood tests are not necessary for those with minor injuries and proved to be ineffective and costly.⁷ In comparison, patients with major blunt trauma injuries will be tested to evaluate haemoglobin, blood clotting function and blood count to assess the extent of the injury.

Treatment of blunt trauma 

Stabilisation and life-saving measures 

The mortality rate of blunt trauma injuries is declining. We need to emphasise the importance of improving the management and resuscitation of blunt trauma patients before they reach the accident and emergency room (A&E). 

Treatment aims to prevent ongoing blood loss and maintain the patient’s airways. Patients with blunt trauma injuries who meet specific triage criteria such as mechanisms of injury, vital signs, type and extent of injury and special considerations (elderly, pregnancy, age and pre-existing medical conditions) have shown improved outcomes. This allows healthcare professionals to assess and prioritise patients and ensure those with the most severe injuries receive prompt care and treatment.¹

Effective communication and collaboration between healthcare professionals are critical to ensure that the patient is receiving appropriate care. The trauma team usually consists of a trauma surgeon, anaesthesiologist, trauma nurses and physicians.

Surgical intervention (if necessary) 

Depending on the type and extent of their injury the patient may require surgical intervention and this will be carefully assessed by the trauma team.

Pain management 

No matter the extent of their injury, patient well-being and care should be the number one priority in healthcare organisations. The patient may be experiencing heightened levels of anxiety and uncertainty while being treated for their injuries, which is normal. 

Providing timely pain management is a must and ensures early healing, reduced stress and shorter hospital stays. Physicians need to carefully assess the required dosage of pain medications as increasing the dosage increases the chances of addiction.⁸

Rehabilitation and recovery

Most patients who meet the triage criteria have shown improvement and with supportive care from doctors and families they can lead a normal life.

Doctors will typically recommend follow-up appointments to monitor the patient’s recovery and provide emotional support and counselling if they are experiencing hardships from their injury. 

Complications and prognosis 

Potential complications

Follow-up appointments can identify possible complications, such as delayed healing or infection.  It is important that these appointments are attended, to assess the individual’s well-being and for doctors to recommend additional medications. 

Long-term outcomes

Victims of blunt trauma injuries typically face psychological, emotional or physical challenges. It may take some time for them to adjust before going back to their normal routine. They can seek assistance from their doctors and loved ones if they feel like they are struggling. Additionally, there are many support groups which they can attend that will support them on their journey to recovery.

Prevention of blunt trauma

While some blunt trauma injuries are serious, they can be prevented by ensuring people’s safety through paying attention to their surroundings. Blunt trauma injuries can be prevented by:¹

• Following health and safety plans carefully 
• Ensuring equipment is in good condition
• Having a first aid kit available
• Wearing protective gear, especially for activities that are at high risk of blunt trauma injuries,  such as riding a motorcycle
• Wearing seatbelts
• Educating people  on the importance of safety

Summary

Blunt trauma injuries are typically caused by vehicle and pedestrian accidents, sports injuries, falls and assaults. When an individual suffers blunt trauma injuries, immediate medical intervention is required especially if the breathing is compromised and there is ongoing blood loss. Common diagnostic tools comprise physical assessment, imaging techniques and blood tests ( for major blunt trauma injury). 

A trauma team of surgeons, physicians and nurses will prioritise care and treatment if the extent of the injury is severe and if the patient is pregnant, has a pre-existing medical condition or is elderly. Blunt trauma injuries may take weeks or even months to heal and may heal on their own without surgical intervention. Major blunt trauma injuries will likely need surgical intervention. Educating people on the importance of safety, such as wearing protective gear and following safety procedures, will reduce the chances of accidents.