Week 1

Question 1

Actual time critical definition

Answer 1

At the time of the vital signs survey the patient is in actual physiological distress

Question 2

Emergent time critical definition

Answer 2

At the time of the vital signs survey the patient is not in actual physiological distress but has a pattern of injury or significant medical condition which has a high probability of deteriorating into actual physiological distress

Question 3

Potential time critical definition

Answer 3

At the time of the vital signs survey the patient is not in actual physiological distress and there is no significant pattern of injury/illness but there is a mechanism of injury/illness known to have a potential to deteriorate into actual physiological distress

Question 4

Actual time critical criteria

Answer 4

1. HR <60 or >120
2. RR <10 or >30
3. BP <90
4. SpO2 <90
5. GCS <13 for 16+ or <15 for paeds

Question 5

Emergent time critical criteria

Answer 5

1. All penetrating injuries (except isolated superficial limb injuries)
2. Serious injury to a single body region that threaten life, limb or long-term quality of life or requires specialised care
3. Significant injury to more than one body region
4. Limb amputation/limb threatening injury
5. Suspected spinal cord injury/spinal fracture
6. Burns >20% TBSA (>10% for <16)/suspected respiratory tract burns
7. High voltage (>1000 volts) burn injury
8. Serious crush injury
9. Major compound fracture/open dislocation
10. Fracture to 2or more of femur/tibia/humerus
11. Fractured pelvis

Question 6

Potential time critical criteria

Answer 6

Mechanism of injury:

1. Motor/cyclist impact >30kph
2. High speed MCA >60kph
3. Pedestrian impact
4. Ejection from vehicle
5. Prolonged extraction
6. Fall from height >3m
7. Struck on head by object falling >3m
8. Explosion

Co-morbidities:

1. Age <12 or >55
2. Pregnancy
3. Significant underlying medical condition

Question 7

Major trauma definition

Answer 7

All trauma patients with injury as their principal diagnosis who meet any of the following criteria:

1. Death after injury
2. ISS >12
3. Admission to an intensive care unit for >24 hrs requiring mechanical ventilation
4. Urgent surgery for intracranial, intrathoracic or intraabdominal injury, or for fixation of pelvic or spinal fractures
5. Injury of the principal diagnosis and satisfying any of the Victorian State Trauma Registry patient inclusion criteria

Question 8

Ideal advanced trauma system factors

Answer 8

1. Advanced prehospital system
2. Rapid identification and dispatch
3. Rapid transport platforms
4. Early notification
5. Satellite receiving centres
6. Expert advice and retrieval
7. Centralised expertise
8. Registry, research and education