Adult Trauma Guidelines - Northerntrauma

Management of severe haemorrhage from midface trauma

Exsanguinating haemorrhage from midface trauma is a rare but potentially catastrophic event. The following is an approach to pack and splint the midface as a bridge to definitive treatment. 1. Intubate the patient Anticipate a difficult airway. In severe midface trauma there will often be increased space Read more…

By Emma Batistich, 1 yearDecember 19, 2022 ago

Trauma Team Member Roles

All team members should identify themselves on arrival to the team leader. Name badges should be visible. Stickers with role identification can be useful. Appropriate PPE should be worn by all. Team leader Who Usually the ED SMO, however a more junior member of the team can team lead Read more…

By hostwynand_1, 2 yearsAugust 15, 2022 ago

Important Aspects of History

AMPLE If you receive a patient that is unstable, after paramedic handover (I MIST-AMBO) an AMPLE history should be retaken in the first instance (if possible) Allergies Medications (especially anticoagulants/platelet inhibitors, betablockers) Past medical history Last ate (when) Events leading to trauma Mechanism of injury When time allows, more information regarding Read more…

By hostwynand_1, 2 yearsAugust 12, 2022 ago

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

REBOA was developed to address the challenge of managing non-compressible torso haemorrhage, a major cause of potentially preventable death after traumatic injury. It involves placement of an endovascular balloon in the aorta to control haemorrhage and to augment afterload in traumatic arrest and haemorrhagic shock states. REBOA is not without significant risk. Read more…

By hostwynand_1, 2 yearsAugust 12, 2022 ago

Extremity Trauma

Limb injuries following trauma are extremely common ED presentations. Some limb injuries can be life threatening External exsanguination from arterial bleeding “internal bleeding” from femoral or other long bone fractures an adult can bleed 1.5L from a single femoral # crush syndrome Other limb injuries are “limb” threatening mangled limbs Read more…

By hostwynand_1, 2 yearsApril 12, 2022 ago

Paramedic handover

Unless the patient is requiring an immediate life-saving intervention, the paramedic handover should be taken prior to moving the patient to the trauma bed. The handover should be systematic with full attention given by all team members. The handover length should ideally take 30-60 seconds. A suggested handover tool Read more…

By jSdj2sn7eH, 3 yearsNovember 10, 2020 ago

Haemothorax

A haemothorax is a collection of blood in the pleural space. It can be caused by penetrating or blunt thoracic trauma. Clinical signs Patients with a massive haemothorax are generally unstable – this should be detected clinically (as part of the primary survey) Smaller haemothoraces Read more…

By jSdj2sn7eH, 3 yearsNovember 7, 2020 ago

Preparation for receiving a trauma patient

Most major trauma patients arrive by ambulance/helicopter with a pre-notification call to the Emergency Department so there is generally time for preparation of staff and equipment. It can be useful to have a whiteboard in the trauma bay where patient demographic and injury/background details can be documented. Team preparation Read more…

By jSdj2sn7eH, 3 yearsNovember 7, 2020 ago

Thoracostomy considerations

Needle thoracocentesis for tension pneumothorax In a patient with a suspected tension pneumothorax, traditional trauma teaching advocated for rapid decompression on the affected side with a 14-16G needle in the 2nd intercostal space in the mid clavicular line. The issues There is a growing body of evidence that this Read more…

By jSdj2sn7eH, 3 yearsNovember 6, 2020 ago

Cervical spine immobilisation and imaging

The issues The practice of routinely placing a cervical spine collar on all trauma patients is being questioned. There are no randomised controlled trials demonstrating that cervical immobilisation prevents secondary spinal cord injury. In fact, there is a growing body of evidence that cervical spine collars may cause more Read more…

By jSdj2sn7eH, 3 yearsNovember 6, 2020 ago