ABC of major trauma. Handling distressed relatives and breaking bad news.

Problems associated with breaking bad news in cases of trauma * Death or severe injury is sudden and unexpectedCoping with major trauma is stressful for both staff and the relatives. * The victim is often youngHandling distressed relatives is an underemphasised part of the work, and * The prognosis is often unsure medical staff may have had no training and little experience of it.It is a time * Staff are often very busy that the relative will always remember and, if handled badly, will leave * Relatives may already have been notified lasting scars. in an unskilled manner * The victim may have committed suicide * Alcohol intoxication may have been a contributing factor Various outcomes of major trauma Giving bad news is never easy, but it can be especially difficult in cases of * Death major trauma.The nature of the patient's problem and the bad news can be * Serious head injury very varied.The management of the relatives may begin before they arrive * Multiple injuries at hospital and carry on until well after death or discharge of the patient.* Spinal injury The principles of management apply to the accident and emergency * Major burns department as well as the intensive treatment unit or admitting ward.* Loss of a limb Providing genuine understanding and support for relatives is the key to * Loss of sight their management. Initial contactWhen a victim of major trauma arrives in the emergency room the priority is immediate resuscitation.Once the victim has been identified the closest relatives or friends should be notified.