Contents:

Protocol for paging Trauma team The Trauma Team Primary Survey Secondary Survey Radiology Placement Head injuries Spinal Injuries Chest Injury Blunt abdominal Trauma Penetrating abdominal Trauma Urological Injuries Eye Trauma

Hand Injuries Burns Carbon monoxide poisoning Obstetric Trauma Paediatric Trauma Paediatric resuscitation chart Hypothermia Universal Precautions Blood Alcohol Testing Patient transfers into Liverpool Patient transfers out of Liverpool Telephone numbers Acknowledgments

Studies conducted in the United States and here at Liverpool Hospital have shown that hypothermia (defined as a core temperature less than 35°C) affects approximately 20% of seriously injured patients.

It has further been shown that patients who develop core temperatures of between 32°C and 35°C have an increased mortality, and that those whose core temperatures fall below 32°C are unlikely to survive.

Hypothermia is more common:

• In females
• As the severity of the injury increases
• With burns

CAUSES

The reasons why patients develop hypothermia are:

• Exposure at the scene
• Exposure in Emergency during assessment
• Administration of IV fluids that are below body temperature
• Impaired thermoregulation due to anaesthesia

PREVENTION

Prevention of hypothermia is an important part of the resuscitation, and the following measures to prevent hypothermia should be instituted

• Monitor core temperature
• Minimum necessary exposure for a full examination. Cover the patient afterwards
• Pre-warm IV fluid in a warming cabinet
• Give blood through a warmer. The Level 1 rapid infusion system is always available
• Use the 'Bair Hugger', especially in CT

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