ER Staff Meeting Trauma Update Zach Stanford RN

ER Staff Meeting Trauma Update Zach Stanford, RN, CCRN, TCRN, CEN Trauma Education November 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 • Primary Charge Nurse recommendation 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

Trauma Ed. Update • BRN has received our application to be a CE provider and has given a 4 to 6 month time frame for a response • In December going to try and put together a “Trauma Boot Camp” – basically a 4 hr trauma specific skills day…more info to come • Our Next Trauma Education Council Meeting is Wednesday, November 16 th at 9 am in the admitting conference room • Our first Trauma Case review presentation will be held Monday, Nov. 21 st from 8 -9 am in MOB Rm 4

It’s good…. Trauma Info But somethings missing…. Stats for October • 219 trauma patients for October • 7% increase from last year • Approx. breakdown • • 15%52%12%21%- Alpha (33 pts) Bravo (114 pts) ER Consults Limited (45 pts) • 51% were admitted Trauma Charting: Chart audits have not happened yet…but I am noticing the following areas that need attention: • Completing Intake/Outputs (if it is zero…put zero) • Activation Time • Level of activation • C-Collar removal time or Aspen placement time • Backboard (a. k. a “lsb”) removal time

Trauma Info I’ve been noticing and hearing a trend with overall trauma charting and maybe even trauma care Trauma care…including it’s charting… is a team effort. Sometimes a trauma patient is quickly moved out of the trauma room because of an in-coming code. If you receive a trauma patient, please look at the trauma flowsheet. If you see information missing that you are not able to fill in, please let the prior nurse know so they can complete the chart. Also, if you notice basic trauma/patient care not done…High blood pressure, still in pre-hospital c-collar, dirty wounds…etc. Please address these issues with prior nurse and or Trauma Doc

Walk-in Trauma Triage Reminder…. The only trauma activation from the lobby are Alpha Traumas…all others please follow standard ER triage procedures

Trauma Ed Highlight Reminder from Radiology to please use Trauma Gurneys for Trauma Patients • Use Trauma Gurneys • Don’t Forget the I. O. For patients who are in extremis or coding: • 1 attempt at peripheral IV • Place I. O. (humoral or tibial) while you are waiting for central line placement