ER Staff Meeting Trauma Update Zach Stanford RN

ER Staff Meeting Trauma Update Zach Stanford, RN, CCRN, TCRN, CEN Trauma Education December 2016

Trauma Orientation Staff requirements for orientation • Two years nursing experience-(ICU/ER experience preferred) • One year employment seniority • Triage trained • TNCC, CEN or CCRN • Recommendations from Primary Charge Nurse and ER Management discretion Staff currently going through orientation • Brian Forest – Just completed • Caroline Tran – about ½ done • Brook Estrada – scheduled • Noelyn Berger – to be scheduled

2016 Trauma Case Reviews 1 page Case Review • May 13 – TBI to Donation • May 26 – Complex Airway • July 18 – Transfer MTP • July 31 – Coroner Case Power Point Slide Shows (download slides to maintain format and links) • August – Le Forte III • September – Below the Seatbelt Sign • October – Tourniquet Use • November – T-Bone Collision • December – Auto Ped “Choose Your Own Adventure” Job security when you hear, “Hey guys, watch this!”

2016 TCRN Review Questions • • • July August September October November December The Trauma Certified Registered Nurse (TCRN) exam incorporates the body of knowledge in trauma nursing across the continuum of care, from injury prevention through reintegration to home. BCEN® recommends two years of trauma nursing experience at an average of 1, 000 practice hours per year across the trauma care continuum (trauma nursing practice defined as providing direct care, supervision, education, and advocacy for trauma patients and their families). Also, twenty (20) to thirty (30) hours of trauma specific coursework across the trauma continuum. Upon successful completion of the certification exam, the TCRN credential is valid for a period of 4 years.

What Triggers a Trauma Chart Audit? Trauma Chart Audit Fields

How can I avoid the audit emails? • If you transition to EPIC, close your “paper” trauma chart! • Top 3 areas that are missed: • Total Intake/Output (total it to that point in time – just like a shift change) • IV –Size / site / fluids • C-Collar removal (or placement of Aspen) ***Trauma Chart Audits are ONLY done on the PAPER chart – NOT on the EPIC charting*** “I knew I should’ve brought a pen to work!”

Open Fracture Standard of Care • For open fractures, standard of care is antibiotics started within 1 hour of patient arrival Ask your Trauma Doc… “Would you like 1 gm or 2 gm Ancef and a Tdap (if appropriate)”

Trauma Ed Highlight There’s nothing worse as a Trauma nurse than to find your stocked trauma room pillaged with an Alpha Trauma on the way. • Do NOT use the Trauma Rooms as a supply room

Trauma Ed Highlight • Do NOT use the Trauma Room transport monitors for non-resus room patients The transport monitors in room 1 and room 2 are dedicated for those patients only There have been times that a Critical patient in the Resus Rooms needed to go to CT/IR/OR and could NOT because both transport monitors were being used for non-resuscitation room patients.