Management of Trauma Patients in an Emergency Department of Iraqi Hospital

Background: Emergency departments frequently work under conditions of limited diagnostic and therapeutic resources, including restricted access to advanced imaging modalities, shortages of blood products, and overcrowding. Standard trauma management protocols rely primarily on quick assessment, which is supported by radiological investigations and laboratory tests. However, in limited resources situations, doctors must frequently rely on clinical judgment and make judicious use of available investigations. Objectives: To assess the clinical presentation, management methods, and short-term results of trauma patients treated in an emergency department of Azadi Teaching Hospital. Methods: This a prospective observational study conducted in the emergency department of Azadi Teaching Hospital in Kirkuk during the period from March 2024 to December 2025. The study included 100 consecutive trauma patients and excluded patients who dead on arrival, patients transferred after definitive treatment elsewhere and those with minor injuries not requiring medical intervention. Results: The study included 100 trauma patients. The mean age was 31.4 ± 12.6 years (ranging from 16 to 68 years). Males formed 76% of the patients, while females accounting for 24% with male: female ratio of 3.16:1. Moreover, 45% of the study patients had road traffic accidents, 22% of the study patients had fall from height, 18% had assault related injury, 10% had occupational injuries, 3% had burn and 2% had animal related injury. It’s evident that 62% of the study patients arrived within 2 hours, to less extent 28% arrived in between 2-6 hours and only 10% had delayed presentation. Furthermore, 81% of the study patients had blunted trauma while only 19% had penetrating trauma. The majority of patients had head and neck trauma (34%), followed by extremities injury (29%), chest in (18%), abdomen in (14%) and multiple injuries in (5%). Additionally, (64%) patients managed conservatively, while (12%) patients did laparotomy, (14%) patients did fixed fracture and (10%) patients did chest tube insertion. Most of patients (72%) were recovered without complications, (6%) patients admitted to intensive care unit, (18%) developed complications and (4%) were dead. Mortality was mainly associated with severe head injury (2 patients) and polytrauma (2 patients). Conclusion: Trauma primarily affects young adult males, with road traffic accidents being the major cause of injury and blunt trauma, particularly head and neck injuries being the most common pattern. The majority of patients were treated conservatively and had favorable outcomes, with severe brain injuries and polytrauma being the most common causes of death. These findings underscore the persistent cost of preventable trauma among economically productive age groups, emphasizing the significance of early emergency response and timely care.