The tissue damage caused by the injury triggers a complex physiological chain reaction inside the victim’s body.
More than the wound itself, this chain reaction breaks down the body’s defenses and takes the victim into the process of dying.
Unless the triggers are controlled – oxygen starvation, pain, hypothermia, sepsis – the post-injury stress response will spin off uncontrolled. And the victim will die.
The trauma outcome – survival or death – does not depend on simple severity calculations based on anatomical indicators.
As important is the period of shock = time of oxygen starvation at cellular level.
Important: the time until blood transfusion is re-established in the tissues. The window of opportunity is 2 hours. After that, reperfusion syndrome develops which is a vascular catastrophe and a potent trigger of post-injury stress complications..
Important: the time until dirty wound tracks are cut clean by surgical debridement. The window of opportunity is 8 hours. After that sepsis explodes and triggers the post-injury physiological derangement.
In damage control, time is a critical factor !
By Hans Husum