Trauma Team Activiation - | Health
Canberra Hospital and Health ServicesClinical Procedure Trauma Team ActivationContents TOC \h \z \t "Heading 1,1" Contents PAGEREF _Toc505680940 \h 1Purpose PAGEREF _Toc505680941 \h 2Alerts PAGEREF _Toc505680942 \h 2Scope PAGEREF _Toc505680943 \h 2Procedure PAGEREF _Toc505680944 \h 3Data collection PAGEREF _Toc505680945 \h 4Implementation PAGEREF _Toc505680946 \h 4Related Policies, Procedures, Guidelines and Legislation PAGEREF _Toc505680947 \h 5References PAGEREF _Toc505680948 \h 5Definition of Terms PAGEREF _Toc505680949 \h 5Search Terms PAGEREF _Toc505680950 \h 5PurposeThis Clinical procedure aims to identify those patients presenting to Canberra Hospital and Health Services (CHHS) with suspected or confirmed life-threatening injuries who require immediate, expert assessment, resuscitation and treatment.Back to Table of ContentsAlertsAlertsThe medical or nursing team leader may upgrade from a trauma alert to a trauma code at any time, based on physiology or if additional personnel are urgently requiredIn order to identify patients who require tertiary survey, the EDIS “Trauma Alert” box should be ticked for those patients with the following mechanism:Motor Vehicle Accident (MVA) >60km/hrPedestrian/cyclist hit by car >30km/hrEjection from vehicleFatality in vehicleExtraction time >20minsFall >3 metresObstetric: >24 weeks gestation call “Obstetric Trauma Alert or Code” - this will alert the Obstetric Registrar to attend. Delivery suite should also be requested to attend to perform CTG monitoring. Any indication of delivery in ED – NICU team must be calledTake particular care & if in doubt, err on the side of calling a trauma alert for patients:over 70 years of agewho are anticoagulated or have a history of bleeding disorderBack to Table of ContentsScopeThe trauma team is the central element of trauma care and management and refers to a multidisciplinary group of health care professionals who aim to provide the multi-trauma patient with immediate, expert assessment, resuscitation and treatment. Trauma team activation occurs from the Emergency Department (ED) and should be initiated by the triage nurse prior to, or on, patient arrival. There may occasionally be instances where the trauma team is called to the Intensive Care Unit (ICU) or Operating Theatres (OT), however this is very rare. The Trauma Team Activation Clinical Procedure includes all patient age demographics.Trauma Code Team MembersMembers of the trauma team are allocated by the Trauma Team Leader:Trauma Team Leader (ED Registrar/Consultant) / Nursing Team LeaderAirway Doctor (ED, ICU or Anaesthetics Registrar/Consultant) / Airway NurseCirculation Doctor (ED or ICU Registrar/Consultant) / Circulation NurseProcedure Doctor (ED or Surgical Registrar/Consultant) / Procedure NurseRadiographer Wardsperson (blood bank runner)Note – The above response should occur for trauma codes in almost all cases, however, ED team response may be varied at the discretion of the Senior ED Doctor & Nurse according to resources required for other seriously ill/injured patients in ED at the time.Subspecialists who may be allocated to the teamWhile not necessarily involved as a part of the trauma team, these members act as consultants in care, and facilitate the progression to definitive care.Neurosurgical RegistrarCardiothoracic RegistrarPlastics RegistrarOrthopaedic Registrar Radiologist Back to Table of ContentsSection 1 – General InformationA Trauma Code or Trauma Alert must be activated for either:notification received of imminent patient arrivals meeting the below criteria, or actual arrival of injured patients with the below criteriaDial 8 and state Trauma Code/Alert. Ensure the EDIS box for Trauma Code or Alert is checked (please see notes for additional information). Back to Table of ContentsSection 2 – Criteria for Trauma CodeRequired response: ED, Trauma, ICU, Anaesthetics, Radiographer, WardsmanTriage category 1Injuries:Airway – intubated, compromised, or evidence of airway burnsAll penetrating injuries to the head/neck/chest/abdomen/pelvis/groin/backFracture of 2 or more long bonesCrush injury or amputation of a limbBurns >20% BSASpinal cord injury with any neurological deficitVital Signs:Heart rate <50 or >120Systolic BP <90 (child below 5yo <70)Respiratory rate <10 or >29 (child below 5yo >40)Glasgow Coma Score 13 or lessBack to Table of ContentsSection 3 – Criteria for Trauma Alert 1Criteria for TRAUMA ALERT 1Required response: ED, Trauma onlyTriage category 2Mechanism Criteria:Any form of traumatic mechanism that does not meet trauma code criteria (for example: Motor vehicle/motorcycle/cyclist/pedestrian accident or Fall > 3 metres ) with established or potential serious injuries i.e. stable isolated fractured femur Trauma alerts should only be called after patient arrival and assessment by triage nurse. ANDMeets triage category 2 criteria in line with National guidelines Other Criteria:Pregnancy >24 week or unsure of dates 2Transfers from other hospitals should be discussed with the admitting officer, triage nurse and the transport team as to the patient’s injuries, physiological stability and therapeutic requirements before deciding on trauma alert versus code versus Cat 3. Back to Table of ContentsEvaluationThe Trauma Coordinator will review all moderate – severe trauma patients presenting to the hospital on a daily basis. This will be monitored and collected daily and all data collected will be stored in the Trauma Registry. KPI reports will be generated monthly and presented to the ACT Trauma Committee for appropriate action. Back to Table of Contents Implementation This Clinical Procedure will be discussed at Multidisciplinary meetings and in existing program of education including in-services. It will be sent to staff via email and will be available via the ACT health Intranet in Policy/Clinical Guidance.Back to Table of ContentsRelated Policies, Procedures, Guidelines and LegislationPoliciesTrauma team roles and responsibilitiesMajor trauma admission policyConsent and TreatmentLegislationHealth Records (Privacy and Access) Act 1997Human Rights Act 2004Work Health and Safety Act 2011Back to Table of ContentsReferencesP Jenkins, J Rogers, A Kehoe, JE Smith (2015) An evaluation of the use of a two-tiered trauma team activation system in a UK major trauma centre, Emergency Medicine Journal, 32(5):364-367P. A. Cameron, B. J. Gabbe, K. Smith, B. Mitra (2014) Triaging the right patient to the right place in the shortest time, British Journal of Anaesthesia, 113(2):226-233D. Tiel Groenestege-Kreb, O. van Maarseveen, L. Leenen, S. J. Howell (2014) Trauma Team, British Journal of Anaesthesia, 113(2):258-265Back to Table of ContentsSearch Terms Trauma, Trauma team, Activation, Trauma team Activation Back to Table of ContentsDisclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Services specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.Policy Team ONLY to complete the following:Date AmendedSection AmendedDivisional ApprovalFinal Approval This document supersedes the following: Document NumberDocument Name ................
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