Items tagged with ENGLISH

Make early contact with ARV for advice from the major trauma services and to initiate retrieval.

• Blunt and penetrating abdominal trauma have different care pathways.
• Delay in diagnosis and treatment of hollow viscous injury leads to an increase in mortality and morbidity.
• Indications for emergency laparotomy rely on haemodynamic instability.

Make early contact with ARV for advice from the major trauma services and to initiate retrieval.

• Early identification of coagulation status is vital to initial management.
• Bleeding can rapidly become life threatening in the patient taking oral anti-coagulants.
• Early consultation with trauma services and haematologist via ARV will guide ongoing management.

Post-resuscitation care, prioritising surgical haemorrhage control and fluid resuscitation to target SBP 90mmHg (110mmHg if there is a head injury) or consciousness until this is achieved.

Make early contact with ARV for advice from the major trauma services and to initiate retrieval.

• The primary survey is designed to detect and treat actual or imminent life threats.
• Avoidance of hypovolaemia in trauma is a cornerstone of management.
• Trauma patients are at risk from complications due to hypothermia.

All penetrating injuries (except isolated / superficial limb injuries)

Blunt injuries:

• Serious injury to a single body region such that specialised careor intervention may be required, or such that life, limb or long term quality of life may be at risk.
• Significant Injuries involving more than one body region.

Specific Injuries:

• Limb amputations / limb threatening injuries.
• Serious crush injury.
• Major compound fractureor open dislocation.
• Fracture to two or more of the following: femur / tibia / humerus.
• Fractured pelvis.

Burns:

• Burns > 20% (adult) or 10% (child).
• Suspected respiratory tract burns.
• High Voltage Electrical Injury.

Neuro-trauma:

• Neurological deficits.
• Skull fracture.
• Abnormal CT scan findings.

Spinal trauma:

• Significant spinal fracture.
• Minor spinal cord or nerve root injury.
• Presence of neurological deficits.
• In isolated spinal cord trauma, the patient should be transferred from a primary hospital to the Victorian Spinal Cord Service – Austin Health, paediatric patients should be transferred and managed at the Royal Children’s Hospital.

Paediatric Trauma:

• Any of the above conditions when inchildren are indications for transfer in a paediatric patient.

Obstetric Trauma:

• Evidence of fetal distress.
• Fetus beyond 24 weeks gestation.
• Possibility of trauma to the uterus.
• All obstetric major trauma patients should be transferred to the RoyalMelbourne Hospital where they will have urgent obstetric assessment.

Make early contact with ARV for advice from the major trauma services and to initiate retrieval.

• Fetal survival depends on effective maternal resuscitation.
• Maternal position – 1 or 2 handed manual uterine displacement or left tilt 15-30*.
• Maternal hypovolaemia will significantly impact on fetal outcomes.

Make early contact with ARV for advice from the major trauma services and to initiate retrieval.

• Older patients are more vulnerable and less adaptable to physiological changes due to pre-existing health issues.
• A high index of suspicion of injury should be considered even with mild injury mechanism.
• Medications may mask signs of shock.

Make early contact with PIPER for advice from the Paediatric Major Trauma Service & to initiate retrieval.

• Delayed management of the obstructed airway and inadequate fluid resuscitation are two of the most preventable causes of death in paediatric patients.
• The family of an injured child requires appropriate support and explanation.