Adult Trauma Guidelines - Northerntrauma

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, 2 monthsJune 10, 2024 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, 2 monthsJune 10, 2024 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, 2 monthsJune 10, 2024 ago

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, 2 yearsDecember 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, 4 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, 4 yearsNovember 7, 2020 ago