Atraumatic versus Nontraumatic

[Wise Young]

Originally Posted by Faye

You just made me aware of the term atraumatic sci as opposed to non-traumatic sci. Thanks.

I think the term atraumatic is much more appropriate than the term non-traumatic, since all sci are a "traumatic" experience in the common use of the word traumatic.

The general public defines traumatic as an emotional event.

Faye, this is a continuation of a discussion from http://carecure.org/forum/showpost.p...7&postcount=20

Thank you for bringing up the implications of the words non-traumatic or atraumatic. Neither the words "atraumatic" or "atraamatic" is defined in most dictionaries. However, amongst surgical circles, the word is most frequently used to refer to procedures that mean non-damaging to tissues.

Several dictionaries, however, define the word "traumatic"

From The Collaborative International Dictionary of English v.0.48:

Traumatic \Trau*mat"ic\, a. [L. traumaticus, Gr. ?, from ?, ?, a
wound: cf. F. traumatique.] (Med.)
(a) Of or pertaining to wounds; applied to wounds. --Coxe.
(b) Adapted to the cure of wounds; vulnerary. --Wiseman.
(c) Produced by wounds; as, traumatic tetanus. -- n. A
traumatic medicine.
[1913 Webster]

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From WordNet (r) 2.0:

traumatic
adj 1: of or relating to a physical injury or wound to the body
2: psychologically painful
3: causing physical or especially psychological injury; "a
stabbing remark"; "few experiences are more traumatic than
losing a child"; "wounding and false charges of
disloyalty" [syn: stabbing, wounding]

On the other hand," trauma" refers to

From WordNet (r) 2.0:

trauma
n 1: any physical damage to the body caused by violence or
accident or fracture etc. [syn: injury, hurt, harm]
2: an emotional wound or shock often having long-lasting
effects [syn: psychic trauma]
[also: traumata (pl)]

The term atraumatic has a further difficulty in that it is often used to mean injury avoidance. For example, the Dictionary of Difficult Words defines "atraumatic" as "designed to avoid injury". Atraumatic skin or vessel punctures (Source means to do these procedures without damaging tissues. "Atraumatic occlusion" refers to clamping of the blood vessels without damaging the vessel (Source). "Atraumatic needles" indicate needles that do not cause injury. Thus, there is indeed a problem with both the words non-traumatic or atraumatic because they connote that there is no tissue or no emotional damage associated with the injury. From that point of view, non-traumatic or nontraumatic may be better and have less history of injury avoidance and more implication of not being caused by trauma. Even though I used the word atraumatic, I am thinking that perhaps we should switch to "nontraumatic".

Wise.

[SCI-Nurse]

When we are tracking our program statistics we often have a debat over surgically cause SCI (such as post-spinal stenosis surgery or infarct related to a AAA repair). Dr. Young, would you consider a surgical mishap a traumatic or non-traumatic injury? The Model Systems apparently consider this traumatic, which we don't necessarily agree with.

(KLD)

[rfbdorf]

During my wife's first stay in rehab, her physiatrist mentioned something about "your injury was not due to trauma", and I disagreed with her, as it occurred during back surgery. She explained that they did not consider things that happened during surgery to be trauma, it was applied only to things like auto accidents, etc.
My take on it is that the body does not distinguish between the surgeon's scalpel and the thug's shiv. It has no way of knowing the motivation behind the blade; it works as hard on healing one cut as on the other, and can do no more.
- Richard

[Wise Young]

Originally Posted by SCI-Nurse

When we are tracking our program statistics we often have a debat over surgically cause SCI (such as post-spinal stenosis surgery or infarct related to a AAA repair). Dr. Young, would you consider a surgical mishap a traumatic or non-traumatic injury? The Model Systems apparently consider this traumatic, which we don't necessarily agree with.

(KLD)

KLD,

I guess that it depends on the cause of the injury induced by surgery. Contrary to popular opinion, most cases of spinal cord injury associated with surgery are not due to mechanical damage of the spinal cord. Most surgeons take a lot of care not to mechanically damage the spinal cord. It is more likely to be due to ischemia (from compression or injury to blood vessels feeding the spinal cord). I would not classify most spinal cord injury complications from surgery to be due to trauma. On the other hand, if a surgeon were to mechanically injure the spinal cord during surgery, that would be definitely traumatic.

My opinion is not as important what doctors and the public think when they hear the words "atraumatic" and "nontraumatic". The word atraumatic means non-injurious to many doctors. Non-traumatic implies that the injury is not directly due to mechanical injury and is more related to immune attack, ischemia, infection, or other non-traumatic causes. We need to seriously think about the name that we apply to the condition because it may cause more confusion than it clarifies the conditions.

Wise.

[Wise Young]

KLD,

I am finding more and more literature references to the term non-traumatic spinal cord injury (as opposed to atraumatic spinal cord injury). This is becoming a standard medical term.

Wise.
[*] Nair KP, Taly AB, Maheshwarappa BM, Kumar J, Murali T and Rao S (2005). Nontraumatic spinal cord lesions: a prospective study of medical complications during in-patient rehabilitation. Spinal Cord 43: 558-64. STUDY DESIGN: Prospective study between 1st Jan 1995 and 31st Dec 1999. OBJECTIVE: To document medical complications among subjects with Nontraumatic Spinal Cord Lesions (NTSCL) during in-patient rehabilitation. SETTING: Bangalore, India. METHODS: Persons with NTSCL admitted for in-patient rehabilitation were included in the study. Clinical evaluation was carried out according to The International Standards for Neurological and Functional classification of Spinal Cord Injury. Disability was quantified using Barthel index. All medical complications were documented. RESULTS: A total of 297 subjects (154 men and 143 women) with NTSCL were included. The number of medical complications in each patient varied from 0 to 17 (mean=6.1+/-3.7). Common complications seen were urinary tract infections (184), spasticity (169), pain (149), urinary incontinence (147), depression (114), respiratory tract infections (101), constipation (92), pressure ulcers (89), contractures (52) and sleep disturbance (43). The number of medical complications correlated positively with duration of stay (Pearson's correlation coefficient r=0.5, P<0.01) and negatively with Barthel Index at admission (r=-0.2, P<0.05) and at discharge (r=-0.2, P<0.05). Complications were more frequent among people with tetraplegia than those with paraplegia (P<0.001). CONCLUSIONS: Medical complications are frequent among subjects undergoing rehabilitation for NTSCL. Patients with severe disability at admission have more complications during rehabilitation. Conversely, individuals with more complications have greater disability at discharge. Department of Psychiatric and Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bangalore, India. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15824754

[Sue Pendleton]

Originally Posted by Wise Young

KLD,
My opinion is not as important what doctors and the public think when they hear the words "atraumatic" and "nontraumatic". The word atraumatic means non-injurious to many doctors. Non-traumatic implies that the injury is not directly due to mechanical injury and is more related to immune attack, ischemia, infection, or other non-traumatic causes. We need to seriously think about the name that we apply to the condition because it may cause more confusion than it clarifies the conditions.

Wise.

Could this be due to the spread of the Greek root of medical terms such as "tetraplegia" rather than Latin based "quadriplegia"? I remembering a German doctor saying "non-traumatic" in reference to my spinal infarct and I opined that it was rather traumatic to me. Several doctors in the US have scribled "atraumatic" which sure beats "CVA" and me wondering how I got the last of that medical class as a doc.