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Trauma approach

Resources

Management of trauma can often be tricky, which is why a systematic approach to trauma is essential. 

Assessment in trauma is divided into a primary, secondary and tertiary survey.

PRIMARY
There are 5 main components of a primary survey:

AIRWAY AND C-SPINE CONTROL
Ensuring airway patency
C spine precautions
Basic airway manoeuvres +/- adjuncts

BREATHING AND VENTILATION
Look asymmetry, external bruising/bleeding
Signs of tension pneumothorax will need immediate needle decompression followed by formal ICC

CIRCULATION AND HAEMMORHAGE CONTROL - Assessing for Blood Loss in the following areas-
ICH
Thorax -Hemothorax / Large veesel injury
Abdomen - Solid or Hollow viscera
Pelvis - Veins, arteries
Fracture related blood

BP, HR, capillary refill
Bloods, IV access
Aim for minimal volume resuscitation
Identify areas of potential bleeding: chest, abdomen, retroperitoneum, pelvis, long bones and externally
Consider activating MTP
FAST scan
Early surgical intervention

DISABILITY
Check pupils
Seek and treat hypoglycaemia
Focal neurology
Seizure treatment

EXPOSURE AND ENVIRONMENTAL CONTROL
Expose patient to identify any potential life threatening injuries, being mindful to not cause hypothermia

​The ABCDE approach should be used not just for trauma patients but for all patients to help identify and treat life threatening injuries early. It is essential to continuously reassess ABCs as a patient’s haemodynamic status can change.
 
SECONDARY SURVEY

The secondary survey is a top to toe examination that should be done once the primary survey is done and immediate life threats have been addressed.

Do not forget to take a short AMPLE history
A - Allergies
M - Medications
P - Past medical
L - Last Meal

IMAGING
Usually Trauma Screen includes
CXR
C Spine
Pelvis
FAST Scan

LABS
Usually a 'TRAUMA PANEL' includes
Vgas
FBC
UELFT
Lipase
BHcg
Coag / INR
Group and Hold
 
TERTIARY SURVEY

The tertiary survey is a repeat of the secondary survey, and aims to identify any potentially missed injuries. Also comprehensive review of all LABS, IMAGING and SPECIALIST opinions.
 

Emergency Medicine - Cadogan & Brown

Adult Trauma

Adult C spine injury guidelines TPCH
Adult Head injury guidelines TPCH
​
Life in the fast lane

Paediatric Trauma

LCCH Paediatric Trauma Guidelines
Paediatric C Spine Guidelines
Paediatric Advanced Care in Trauma (PACT) Online Course

Trauma Documentation - a sample of a Trauma Record

Copyright © 2015
  • Home
  • Guidelines
    • Abdominal pain in adults
    • AAA Rupture
    • Acute Coronary Syndrome
    • Anaphylaxis
    • Aortic Dissection
    • Appendicitis
    • Asthma
    • Backpain
    • Bowel Obstruction
    • Bronchiectasis
    • Burns
    • Chest Pain >
      • ADP Chest Pain Pathway
    • Cholecystitis
    • Confusion
    • COPD
    • Diverticulitis
    • DKA
    • DVT
    • Eating Disorders
    • Febrile Neutropaenia
    • Fractures >
      • Bier's block procedure form
      • Fractured neck of Femur
    • Funnel Web Spider Bite
    • Headache
    • Influenza Like illness
    • Meningitis
    • Obstetrics >
      • QLD Clinical Guidelines
    • Pancreatitis
    • Paracetamol OD
    • Pathology Ordering
    • Peri-anal abscess
    • Pertussis
    • Pneumonia
    • Pneumothorax
    • Podiatry
    • Procedural Sedation >
      • Procedural Sedation
    • Pulmonary Embolus
    • PV Bleeding in Early pregnancy >
      • EPAU - Early Pregnancy Assessment Unit
    • Redback Spider Bite
    • Ring cutter use
    • Seizure
    • Septic Arthritis
    • Use of Restraints
    • Stroke / TIA
    • Sepsis
    • Smoking cessation
    • Snake Bite
    • Syncope >
      • Telemetry guideline
    • TIA
    • Tonometer use
    • Antidotes
    • Dagibatran reversal guidelines
    • Funnel Web Spider Bite
    • Redback Spider Bite
    • Paracetamol OD
    • Snake Bite
    • Warfarin Reversal Guidelines
    • Trauma >
      • C-spine injury
      • Head Injury
      • Imaging Guidelines
      • Trauma in pregnancy
      • Sutures
    • Abdominal Pain
    • Allergy / Anaphylaxis
    • Antimicrobial Guidelines
    • Asthma & Wheeze
    • Behavioural Disturbance
    • Boils - Staph decolonisation treatment
    • Bronchiolitis
    • Buckle fractures
    • Burns
    • Cervical Spine Guideline
    • Chest Pain (Paediatric)
    • Child Protection
    • Constipation
    • Croup
    • DKA
    • Drowning
    • Eating Disorders
    • Fever
    • Fluids in Kids
    • Foreign Bodies
    • Gastroenteritis
    • Headache
    • Head Injury
    • High Flow Nasal Cannula Oxygen
    • Hypoglycaemia
    • Jaundiced Neonate
    • Limping in children
    • Malaria
    • Meningitis
    • Oncology Emergencies
    • Otitis Externa
    • Otitis Media
    • Paediatric Fracture Clinic Referral
    • Paracetamol Poisoning
    • Petechial Rash
    • Pneumonia (CAP)
    • Seizures / Status Epilepticus
    • Sepsis Guideline
    • Tetanus Prophylaxis
    • Torticollis
    • UTI NICE Guideline
    • Trauma in children >
      • LCCH Paeds Trauma Guidelines
      • C Spine Injury LCCH Guideline
      • LCCH Massive Transfusion
    • RCH Melbourne Guidelines
  • Parent Handouts
    • Accidental Poisoning
    • Abdominal Pain
    • Ankle Sprain
    • Arrhythmia
    • Asthma
    • Bronchiolitis
    • Chest Infections
    • Cast Care
    • Cellulitis
    • Constipation
    • Croup
    • DKA
    • Epistaxis
    • Eye Foreign Body
    • Febrile Convulsion
    • Fever
    • Fracture- Buckle
    • Fracture- Clavicle
    • Fracture- Elbow
    • Fracture- Finger/Toe
    • Fracture- Foot
    • Gatroenteritis
    • Glue- Lacerations
    • Head Injury
    • Jaundice
    • Otitis Externa
    • Parechovirus
    • Periorbital and Orbital cellulitis
    • Pulled Elbow
    • Seizures
    • Tonsillitis
    • Urticaria
    • Viral Illness
    • Wound Care
  • ACE the ACEM
  • Blog