Primary survey and planning

Question 1

List the criteria for trauma team activation.

Answer 1

• Physiologic
  
  • BP < 90
  • RR <10 or >30
  • GCS < 12 or focal neuro deficit
• Anatomical
  
  • Major amputation
  • >=2 long bone #s
  • Major chest injuries
    
    • Flail
    • Haemothorax
    • PTX
  • Penetrating
  • Unstable pelvis
  • Suspected spinal injuries
• Mechanistic
  
  • Ejection from vehicle
  • Pedestrian >30kph
  • High speed or rollover
  • Fall >6m
  • Deceleration injury >30kph
  • >10% BSA
  • Inhalational burns
  • >60y, <16y, pregnant
• Logistic
  
  • Busy dept

Question 2

LIst an approach for (5min) planning for a imminently arriving resus patient.

Answer 2

1. What do we know about the patient?
   
   • Pull notes
   • Details from ambos
2. What do we expect the injuries/immediate patient issues to be?
3. What are we planning to do and contingencies for what might (will!) go wrong?
4. Team roles
5. Other ppl/services - anaesthetics? surg? blood? anti-venom? drugs?

Question 3

List 5 commonly missed trauma injuries.

Answer 3

1. Bleeding scalp
2. Long bone #’s
3. Urethral injuries
4. Posterior injuries -> LOGROLL!!!
5. Penetrating injuries in axilla, buttocks and groin.