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Shocking Images

Karim Brohi karim at trauma.org
Sat Mar 25 00:07:05 GMT 2006

I have to agree with Bill, and I would add that from a pure educational point of view, the use of a 'shock' image usually means that
your next 3-5 slides are not taken in at all as people digest the gore they have just seen.  And there have been studies that show
that teenagers are not deterred by the gore images (witness the success of gore image sites).  More effective are images/stroies of
permanent disability, colostomy bags, quadriplegia etc.

There is no gratuitous gore on the Truama.org imagebank (I don't think) and I reject images every week that have no educational
value and are just plain gross.

My 0.02c to add to Bill's 0.02c :-)


-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Bill Griggs
Sent: 23 March 2006 20:22
To: Trauma & Critical Care mailing list
Subject: Re: Shocking Images

Dear List,

I have been interested and involved in youth driver safety education for 
quite a few years and wrote, fund and maintain a free youth road safety 
website ( http://www.roads2survival.com.au ) and am involved in a number of 
youth road safety programs each year.

As the Director of Trauma at a Major Trauma Service in Australia (US Level 1 
equiv) I have many graphic injury pictures of cases of which I have first 
hand knowledge.

However I have no graphic injury pictures on the Roads 2 Survial website. 
There is only one picture of a wreck and it is a fake being used for 
extrication training.  This is deliberate and the result of market research 
with teenagers (admittedly here is Australia).

I do talk to young people who are about to drive and I will show them car 
wrecks from scenes that I have been to, with an relevent accompanying 
story - ie to me the benefit appears greater is if it first hand and 

I would caution extreme care in using graphic patient/injury  images for a 
number of reasons.  I rarely use any in this context.  Reasons include

1. It is easy to descend into "I have a worse image than the next person" 
but this is meant to be about the young people not about which lecturer can 
be most horrific.

2. Very bad images may actually psychologically traumatise some young 
people - people earlier suggested some web sites where graphic images can be 
obtained - I would be extremely careful about some of these.  What we may 
have grown used to in terms of graphic injury is not necessarily appropriate 
for a teenager.   Something which may "impress" our peers may be very bad 
for a young person.

3. Teenagers are intelligent.  Some/most may feel "bulletproof"  but 
preaching at them and treating them as kindergarten level intelligence will 
minimise any chance of there engagement.  Pleae treat them as intelligent 
adults who have to make their own decisions.  Show them some respect.  Offer 
them information that they may not know.  But the reality is that when they 
get behind a wheel they will decide how they drive.  Remember when you were 
young?  Were the old fogies who "yelled" at you the ones whose opinions you 
respected or even considered?  Not in my memory.

4. Using a graphic crash scene or an injury photo can get their attention, 
but a long stream of gore for no sake other than shock value seems to me to 
any lack educational value.  I would be interested in what anyone with 
significant formal education training and qualifications has to say about 

So my suggestions? - and they are suggestions only - no Level 1 evidence 
here :-)
- Please be careful about pictures with young people.  They are a very 
different audience to our medical peers.  Show car wrecks but be very 
careful about injuries.
- Please remember the risk of inadvertently hurting them by getting caught 
up in an attempt to show how cool you are yourself.
- Consider talking to a professional formally trained educator about these 
- When you do use images use them carefully and with relevence and in 
context and preferably be able to talk about them from first hand knowledge.

My 0.02c

back to lurking.



Dr William M Griggs AM
Director Trauma Service
Royal Adelaide Hospital
South Australia.

----- Original Message ----- 
From: "John Boel" <jboel at ozemail.com.au>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Thursday, March 23, 2006 8:02 AM
Subject: Re: Shocking Images

>I agree that getting into their minds is the way to achieve long term  
>results. I have found that sometimes shocking images act as an 
>"attention  getter" that opens the mind and allows it to comprehend the 
>consequences.  Somtimes you need to break through the warm and fuzzy 
>insulation that is  created by the sanitized media reports of most 
>trauma events and make  people  see the whole story in all of its 
>shocking detail.
> ----- Original Message -----
> From: "Errington Thompson" <errington at erringtonthompson.com>
> To: "'Trauma &amp; Critical Care mailing list'" <trauma-list at trauma.org>
> Sent: Thursday, March 23, 2006 7:21 AM
> Subject: RE: Shocking Images
> Shocking has no long term benefit.  You have to get to their minds.
> E
> Errington C. Thompson, MD, FACS, FCCM
> Trauma/Surgical Critical Care
> Mission Hospital
> Asheville, NC
> Author - A Letter to America
> www.erringtonthompson.com
> Everyone deserves to make an informed decision
> - Errington Thompson, MD
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]
> On Behalf Of bensonblues at comcast.net
> Sent: Wednesday, March 22, 2006 7:54 AM
> To: trauma-list at trauma.org
> Subject: Shocking Images
> Jan, I've been using images to shock young kids into wearing seatbelts 
> and avoiding idiots with guns for years. I give lectures to high 
> schoolers from the inner city Detroit, and these images are often the 
> only thing that stands between reality and fantasy. Shock and awe 
> sometimes is best
> (preventative) medicine. DB
> --
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