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

  • Trauma team members should endeavour whenever possible to arrive to ED prior to patient arrival – in order to have time to prepare themselves and the trauma room for the incoming patient.
  • All team members should introduce themselves to the team leader – name, role and rank.
  • Stickers with the team member’s role and name worn on the outside of the PPE are  helpful and encourage direct communication.
  • The team leader should assign any unfilled roles.  He/she should then brief the team regarding the pre-notification of the patient.  They should convey and synthesise all available information, outlining the potential life threats and immediate priorities for the team.   In many ways, this is equivalent to a surgical ‘time-out’ recommended by the WHO Safe Surgical Checklist.

 

Personal protective equipment

Universal precautions should be undertaken by all patients managing the trauma patient

This should include

  • Gloves
  • Plastic apron or (preferably) full impermeable gown
  • Eye protection
  • Lead aprons + thyroid shield for staff members that might remain in the room when xrays taken

Respiratory protection should be used currently for any patient in whom there is a possibility of respiratory infection (eg Covid-19).  A surgical mask should be the minimum PPE, with an N95 mask used if an aerosol generating procedure is envisioned.

Standard hand hygiene rules apply – use hand gel before and after any contact with the patient or the environment/specimens.

 

Equipment preparation

 

Based on the prehospital notification and the need for various interventions, equipment should be prepared, which might include

  • Advanced airway equipment
    • Guedel/nasal airways
    • Suction
    • Nasal prong oxygen/hudson mask
    • Bag valve mask
    • Video or direct laryngoscope
    • Endotracheal tubes of appropriate size
    • LMA
    • Surgical airway kit available
  • IV insertion equipment prepared
  • IV lines primed, IVFs on a pressure bag
  • Rapid infuser primed
  • Un-crossmatched blood/blood products available if massive transfusion anticipated or any episode of prehospital hypotension
  • Drugs
    • Tranexamic acid
    • RSI drugs
    • Analgesia
    • Antiemetic
  • Pelvic binder (place on bed)
  • Thoracostomy/thoracotomy tray available
  • Ultrasound turned on and ready to scan

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About this guideline

First published: February 2018 (Author: Emma Batistich)
Updated April 2021 (Scott Cameron)
Approved by: Northern Region Trauma Network, ADHB, WDHB, CMDHB, NDHB, NRHL, St John
Review due: 2 years