TRAUMA ACTIVATION TIMELINE Trauma Activation T10 Team Brief

TRAUMA ACTIVATION TIMELINE Trauma Activation T-10 Team Brief Assemble Team • Activate Trauma Call / • Ensure all team present • Role allocation & label • Lead gown & PPE Alert • Consider Obs / Neonatal • Consider MEP Get Ready • Share prehospital information • Equipment & Drugs • Formulate management • Pre-scrubbed Proceduralist priorities • Crowd Control Pre-arrival Initial Assessment T=0 Ambulance Handover • Patent airway • Central pulse • No visible active haemorrhage Treat immediate life threats • Transfer to ED trolley • Silence during handover • IMIST/ISBAR format Arrival Concurrent Primary Survey & Immediate Treatment C T+0 Immediate Actions T+5 After Arrival Control Exsanguinating Haemorrhage 2 x large iv access (peripheral > RIC/CVC > IO) A Actual or impending airway compromise > O 2 / airway manoeuvres > BVM > intubation B Ventilatory failure > O 2 / consider intubation US > finger thoracostomy for tension PTX Review Primary Survey • Reassess ABCD • Treat as necessary Situational Update T+10 • Immediate CT versus transfer to OT/IR • Set goals on physiology C Shock: commence MEP ? Cardiac tamponade > US > ? thoracotomy ? Pelvic fracture > pelvic binder Long bone # > splint & assess vascular supply D Combative patient > Intubation Imaging • CXR, PXR • e. FAST Secondary Survey • May be performed if patient does not require time critical intervention Non Invasive monitoring & 3 lead ECG Trauma bloods / Xmatch / ROTEM Analgesia Prepare for transfer • Reassess splints/dressings • Secure lines • Check equipment After Arrival Command Huddle T+20 After Arrival • Decisions on next steps made by senior members of team • Communicated to whole team Confirm Drugs • Analgesia • Antibiotics • Tetanus prophylaxis Inform Family • The TTL, a senior nurse and social worker will explain the situation to the patient’s family