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Injury
The knee of a person is examined with the help of radiography after an injury.
Specialty	Emergency medicine, traumatology

Injury, also known as physical trauma, is damage to the body caused by external force.^[1] This may be caused by accidents, falls, hits, weapons, and other causes.^[1]Major trauma is injury that has the potential to cause prolonged disability or death. In 2013, 4.8 million people world-wide died from injuries, up from 4.3 million in 1990.^[2] More than 30% of these deaths were transport-related injuries.^[2] In 2013, 367,000 children under the age of five died from injuries, down from 766,000 in 1990.^[2] Injuries are the cause of 9% of all deaths, and are the sixth-leading cause of death in the world.^[3][4]

Classification

Deaths from injuries per million persons in 2012

  203-358

  359-428

  429-483

  484-559

  560-637

  638-716

  717-817

  818-939

  940-1,140

  1,141-2,961

Deaths from intentional injuries per million persons in 2012

  14-65

  66-89

  90-114

  115-137

  138-171

  172-193

  194-226

  227-291

  292-379

  380-2,730

The World Health Organization (WHO) developed the International Classification of External Causes of Injury (ICECI). Under this system, injuries are classified by:

• mechanism of injury;
• objects/substances producing injury;
• place of occurrence;
• activity when injured;
• the role of human intent;

and additional modules. These codes allow the identification of distributions of injuries in specific populations and case identification for more detailed research on causes and preventive efforts.^[5][6]

The United States Bureau of Labor Statistics developed the Occupational Injury and Illness Classification System (OIICS). Under this system injuries are classified by

• nature,
• part of body affected,
• source and secondary source, and
• event or exposure.

The OIICS was first published in 1992 and has been updated several times since.^[7]

The Orchard Sports Injury and Illness Classification System (OSIICS), previously OSICS, is used to classify injuries to enable research into specific sports injuries.^[8][9]

By cause

• Causes for injuries fall under two categories: intentional and accidental. Intentional injuries include acts of violence and war, or be can self-imposed like suicide or self-harm. Accidental injuries can come from falling or motor vehicle accidents.^[10] Some cases of accidental injuries are injury by stingray or lightning injuries.

By modality

• Trauma
  • Traumatic injuries are a body wound or shock produced by sudden physical collision or movement. Injuries associated with trauma are avulsion, bone fracture, injury by blast, internal bleeding and catastrophic injuries.

• Strain, repetitive strain, or sprain
  • Strain and repetitive strain are injuries to muscles or tendons. Sprain is an injury to a ligament or ligaments.^[11]

• Toxins
  • Injury from toxin or as adverse effect of a pharmaceutical drug.

• Other external or internal injuries
  • Other injuries can be from external causes, such as radiation, burn or frostbite. These injuries can include radiation-induced lung injury and microwave burn. Injuries from internal causes include reperfusion injury.

By location

Skin:

• Wound, an injury in which skin is torn, cut or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Head:

• Head injury

• Penetrating head injury
• Closed head injury

Eyes:

• Eye injury

• Chemical eye injury

• Eye injuries during general anaesthesia

Brain:

• Brain injury
• Acquired brain injury
• Coup contrecoup injury
• Diffuse axonal injury
• Frontal lobe injury

Nerves:

• Nerve injury
• Spinal cord injury
• Brachial plexus injury
• Sciatic nerve injury
• Injury of axillary nerve

Soft tissue, musculoskeletal and organs:

• Soft tissue injury
• Tracheobronchial injury
• Acute kidney injury
• Anterior cruciate ligament injury
• Musculoskeletal injury
• Articular cartilage injuries
• Acute lung injury
• Pancreatic injury
• Thoracic aorta injury
• Biliary injury

Body:

• Lisfranc injury
• Knee injury
• Medial knee injuries
• Back injury
• Hand injury
• Chest injury

By activity

• sports^[12]
  • concussion
  • strain
  • shoulder injury
• rock climbing^[13]
  • finger injury
  • knuckle injury
  • Lead climbing injuries

• Reverse bite injury
• Occupational injury
• Ventilator-associated lung injury
• Sea urchin injury
• Illness and injuries during spaceflight

Injury severity score

The injury severity score (ISS) is a medical score to assess trauma severity.^[14][15] It correlates with mortality, morbidity, and hospitalization time after trauma. It is used to define the term major trauma (polytrauma), recognized when the ISS is greater than 15.^[15] The AIS Committee of the Association for the Advancement of Automotive Medicine designed and updates the scale.

See also

• List of causes of death by rate
• First aid
• direct DNA damage
• Ventilator-associated lung injury

• Transfusion-related acute lung injury
• Asphyxia
• Crush injury
• Needlestick injury
• Penile strangulation

References

External links

• International Trauma Conferences (registered trauma charity providing trauma education for medical professionals worldwide)
• Trauma.org (trauma resources for medical professionals)
• Emergency Medicine Research and Perspectives (emergency medicine procedure videos)
• American Trauma Society
• Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine