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

   Radiology departments are dangerous places for all trauma patients if they are not adequately monitored or obsened. An appropriate escort should accompany patient (see next section).

   All multiple trauma patients should have:

1. Airway and oxygenation guaranteed as a first priority, with head immobilisation continuing until cervical spine films have been checked.
2. Lateral cervical spine filnL A hard collar must remain in place for suspected cervical injuries until adequate films down to C7 have been performed. Always have an assistant in a lead apron pull the arms down. Ask for a swimmers view if this is ineffective.
3. An erect chest X-Ray.
4. Pelvic film.

   These initial X-rays should be performed as mobiles during initial resuscitation. The radiographer should be encouraged to perform these films as assessment and treatment proceeds. Failure to do so causes excessive delay for critically ill patients.

   Other X-Rays Should Not Be Performed Until Resuscitation Is Completed And The Patient's Condition Is Stable.

   When stable consideration may be given to performing X-Rays of:

• Cervical Spine full series.
• Thoracic and Lumbar spine with suspected Spinal Injuries.
• Orthopaedic injuries.

   As minor injuries can have major morbidity if missed at this stage, the advice of the Orthopaedic registrar should be sought at the earliest opportunity. Where the injuries are minor and the patient is being transferred to the general wards, the Orthopaedic registrar should be informed so that a full assessment can be made prior to transfer. When possible full X-rays of orthopaedic interest prior to placement of the patient should be performed under the direction of the orthopaedic registrar.

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