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Adult Trauma Guidelines

Traumatic brain injury

Introduction Traumatic brain injury (TBI) is a leading cause of death from trauma and is major cause of disability, especially in children and younger adults.   The 2019/20 NZ National Trauma Networks Annual report identified a caseload of 728 serious traumatic brain injuries over a 12 month period with a Read more
By jSdj2sn7eH, ago

Open Pneumothorax

Also known as a “sucking” chest wound, an open pneumothorax usually results from penetrating chest trauma and creates an air passage from the environment into the thoracic cavity. Depending on the size of the wound, air can become preferentially entrained into the pleural space, causing ipsilateral lung collapse. If air Read more
By Emma Batistich, ago

Cricothyroidotomy

This is a procedure performed at the last stage of the “can’t intubate, can’t oxygenate” (CICO) algorithm.     Indications Can’t intubate, can’t oxygenate Premorbid difficult airway Airway burns Severe facial trauma Obliteration of airway view by massive haemorrhage or vomit   Contraindications Alternative method of securing airway is available Read more
By Emma Batistich, ago

Thoracostomy blunt dissection technique

  Indications   Pneumothorax Consider using a smaller catheter inserted via seldinger technique for uncomplicated pneumothoraces Haemothorax   Contraindications   Drain not indicated or there is an alternative method of insertion (see above) Patient is anticoagulated or has a bleeding diathesis A relative contraindication only If a patient is in Read more
By Emma Batistich, 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, ago

Important Aspects of History in Trauma

SAMPLE 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) Signs/symptoms (note symptoms are important, but they are subjective) Allergies Medications (especially anticoagulants/platelet inhibitors, betablockers) Past medical history Last ate (when) Events leading to trauma Read more
By hostwynand_1, 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, 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 and succinct with full attention given by all team members. The handover length should ideally take 30-60 seconds.   A suggested Read more
By jSdj2sn7eH, ago