Trauma medicine. The fight for life. Part 1 of 2.

In this broadcast, Dr Kevin Fong examines the importance of modern trauma medical practice. Fong outlines the principle that trauma medicine is about creating structure, protocols and order amongst the chaos of a traumatic event such as the London Soho pub nail bombing in 1999. James Styner, an American orthopaedic surgeon, is an important figure in changing the rules and introducing order to trauma medicine. In 1976, he was piloting an aircraft in with his family on board and when the plane crashed in bad weather leaving his wide dead and his four children badly injured, he discovered that when they eventually reached hospital their problems grew worse as the doctors were not sufficiently trained in trauma medical practice and therefore made grave mistakes. He resolved to do something about this and he developed ATLS or Advanced Trauma Life Support. He introduced a programme of trauma life support in the US. Fong's first experience of trauma care was the 1999 nail pub bombing. At one point 95% of people with severe injury would expire rapidly; these days the situation is reversed. On the day of the Boston marathon in 2013, Ricky Kue was on duty at the Boston Medical Center; he attended to the injuries but as an army reservist in Iraq, his experience from the battlefield was helpful. Other trauma medics are interviewed about their experiences of this critical event and a high speed train crash in Japan in 2005. In Japan, so many injured patients were admitted at the same time and so normal rules of triage were abandoned and what later became formalised as 'FIT' First Impression Triage was implemented.