Most people know somebody who has experienced a potentially fatal injury or accident, even if they have not been involved in one themselves. Susceptibility to injury is linked to lifestyle, environment, and gender, with more than twice as many men as women sustaining a life-threatening injury. Age is also an important factor, and statistics show that most injuries and accidents tend to happen in adolescence and early adulthood.
In 2007, there were about 17,500 deaths in England and Wales due to injury or poisoning, of which about 11,800 were accidental.
One of the most common causes of fatal serious injuries is road traffic accidents. In 2007, almost 3,000 people in England and Wales were killed on the roads and about 28,000 were seriously injured.
Poisoning, either intentional or accidental, caused about 2,500 deaths in England and Wales in 2007, and was responsible for over 100,000 hospital attendances in England alone. In adults, poisoning is most often due to a drug overdose. However, most nonfatal accidental poisonings occur in children under the age of 5.
Burns, scalds, and smoke inhalation caused about 220 deaths in England and Wales in 2007 and, in England alone, resulted in about 94,000 people needing hospital treatment. The very young and the elderly are most likely to be seriously injured.
Illness and injury that result from environmental factors, such as altitude and low temperatures, are becoming more common, particularly in young adults. Disorders such as frostbite, hypothermia, and altitude sickness can occur when young people take risks on holidays in remote areas with extreme climates. Hypothermia is a particular threat to elderly people, even at home. This is because the body’s ability to regulate body temperature becomes less effective with old age. However, the most common cause of fatal injury in elderly people is a fall, which often results in one or more bone fractures. In 2007, more than 2,600 people over the age of 65 died in England and Wales as the result of falls.
Some accident statistics indicate improving trends. For example, vehicle safety features are improving survival rates for traffic accidents. The medical management of serious injuries has also improved. Paramedics can now provide resuscitation at the scene of accidents, patients are taken to hospital more quickly, accident departments are better staffed, and intensive therapy units have more effective procedures for dealing with multiple injuries and shock. In addition, trauma centres have been established that specialize in treating patients who are seriously ill.
The nature and location of an injury determines its severity. For example, crush injuries to the torso tend to be more serious than those to the limbs because they may damage internal organs. The severity of gunshot and stab injuries depends on the precise location of the wounds and whether major organs or blood vessels are involved. Poisoning and drowning may affect entire systems and damage vital organs.
The heart may be directly damaged by physical injuries, such as a stab wound, or its function may be impaired by toxic substances in an overdose of drugs.
When the liver is injured by a cut or a blow, a large amount of blood may be lost. Drug overdoses may also damage the liver. The spleen may rupture when crushed or following a severe blow to the abdomen, resulting in severe internal bleeding. A lacerated kidney may leak urine into the surrounding tissue, which causes inflammation. An injury that tears the kidney from its blood supply causes profuse bleeding. If the intestinal wall is damaged, the contents may leak into the abdomen, causing serious infection.
A lung may collapse following a penetrating wound or become inflamed by inhaled gases or smoke in an accident or fire. If the trachea (windpipe) is crushed or obstructed by a foreign body, asphyxia (a potentially fatal lack of oxygen) may result.
Severe burns to the skin’s protective layer may cause large amounts of body fluid to be lost from the circulation, leading to potentially fatal shock.
If the spine is injured, the vertebrae may be fractured or displaced and damage the spinal cord, causing paralysis or death.
The brain may be damaged when a blow or other injury to the head causes internal bleeding and swelling. Such injuries can lead to the formation of a blood clot just inside the skull, causing brain tissue to become swollen and distorted. The skull is also susceptible to fractures.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.