Trauma refers to a body wound or shock produced by sudden physical injury, as from accident, injury, or impact. Other definitions include: "a deeply distressing or disturbing experience", and "a physical wound or injury, such as a fracture or blow." Major trauma (defined by an Injury Severity Score of greater than 15) can result in secondary complications such as circulatory shock, respiratory failure and death. Resuscitation of a trauma patient often involves multiple management procedures. Trauma is the sixth leading cause of death worldwide, and is a serious public health problem with significant social and economic costs.