When Seconds Matter: Why Advance Directives Are Important in Trauma Situations

Most people don't spend much time thinking about trauma care. Car accidents, falls, or other serious injuries are the kinds of events we assume only happen to someone else. 

In trauma situations, medical teams often have to make life-saving decisions in minutes or even seconds. During those critical moments, doctors rely not only on their training and experience, but also on something else that can make a big difference: knowing a patient's wishes. 

This is where advance directives play an important role. 

Advance directives are legal documents that outline the medical care you would want if you were unable to speak for yourself. While many people associate them with long-term illness or end-of-life care, advance directives are just as important in unexpected emergencies. 

"Trauma is unpredictable," says Cianna Pender, MD, general surgeon and medical director of trauma services at Archbold, a Level III Trauma Center located in Thomasville, Georgia. "We take care of patients every day who never imagined they would be in a situation where they couldn't communicate their wishes. Having an advance directive in place can provide important guidance for your family members and your medical team during a very stressful time." 

What Is an Advance Directive? 

An advance directive is a written document that outlines your preferences for medical care if you become unable to make decisions for yourself. 

Common types of advance directives include: 

• Living wills, which specify the types of medical treatment you would or would not want
• Healthcare power of attorney, which designates someone to make medical decisions on your behalf
• Do Not Resuscitate (DNR) orders, which state that you do not want CPR if your heart stops

These documents allow you to maintain control over your healthcare decisions, even if you cannot communicate directly with your medical team. 

"Advance directives are really about making your voice head when you can't speak for yourself," Dr. Pender explains. "They help ensure that the care you receive aligns with your personal values and preferences."

Why Advance Directives Matter in Trauma Care

In trauma care, time is everything. When someone arrives at the hospital after a serious injury, doctors must quickly evaluate the situation and determine the best course of action. 

But trauma patients are often unconscious or otherwise unable to communicate. And without clear guidance, medical teams typically provide every possible life-saving intervention. 

"By default, our goal is always to do everything we can save a patient's life," says Dr. Pender. "However, if a patient has specific wishes about they type of care they want or don't want, advance directives help us honor those preferences while still providing appropriate medical treatment."

Advance directives can help guide decisions related to: 

• Life support or mechanical ventilation
• Emergency surgery
• Feeding tubes or long-term life-sustaining treatments
• Organ donation

For families, these documents can also relieve the emotional burden of making difficult decisions during a crisis. 

"When loved ones are suddenly asked to make medical decisions during a traumatic event, it can be overwhelming," Dr. Pender says. "Having those conversations ahead of time and documenting those wishes can bring clarity and peace of mind in incredibly difficult moments." 

Advance Care Planning Isn't Just for Older Adults

Many people assume advance directives are only necessary later in life. But the reality is, trauma can affect people of any age. 

Car accidents, sports injuries, falls, and other emergencies happen every day, unexpectedly. 

"In trauma care, we treat patients across the entire age spectrum," Dr. Pender says. "Young, healthy people often think these conversations can wait, but the reality is that emergencies don't follow a timeline."

Creating an advance directive is a proactive step anyone can take to ensure their healthcare wishes are respected. 

It also opens the door to meaningful conversations with family members about medical preferences, values, and care goals. 

A Good Time to Start the Conversation

April serves as an important reminder to think about these decisions. 

National Healthcare Decisions Day, observed on April 16, encourages individuals to learn about advance care planning and share their wishes with loved ones. 

April is also Donate Life month, which highlights the importance of organ and tissue donation, another decision that can be included in advance care planning. 

"Both of these observances encourage people to think about how their choices can impact others," Dr. Pender says. "Organ donation, for example, can save lives and give hope to patients who are waiting for a transplant."

While these observances help draw attention to the topic, the most important step is simply to create the advance directive. 

How to Create an Advance Directive

Creating an advance directive is often easier than people expect. Many states provide free forms that can be completed online or with the help of a healthcare provider or attorney. 

To get started:

• Think about your values and preferences regarding medical care
• Choose a trusted person to serve as your healthcare decision-maker
• Complete the appropriate advance directive forms for your state
• Share copies with your family and your healthcare providers

"An advance directive documents your healthcare preferences, but discussing those decisions with your family is equally important," Dr. Pender says. "Those conversations help ensure everyone understands what matters most to you."

Why Planning Ahead Matters for You and Your Family

While no one likes to imagine facing a medical emergency, planning ahead can make a big difference for both patients and their families.

Advance directives provide clarity, reduce uncertainty, and allow medical teams to focus on providing care that reflects a patient's wishes. 

"Taking the time to have these conversations now is one of the most thoughtful things you can do for your loved ones," Dr. Pender says. "It helps ensure that if the unexpected ever happens, your care aligns with what matters most to you."

Advance Directives: How We Can Help

At Archbold, our patient advocates are here to guide you through the advance care planning process. They work with patients and families to answer questions, provide educational resources, and assist with completing the legal documents needed to record your wishes. 

You don't have to be a patient at an Archbold facility to take advantage of these services. Anyone in our community is welcome to reach out for support in creating an advance directive or care plan. 

Ready to start the conversation? 

call 229.228.8224 to speak with a representative who can help you begin the process. You can also find more information and tools online to help you think through your healthcare decisions and how you'd like to document your wishes.