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

1. The Team Leader

   The Emergency registrar and ICU registrar fill this position on an alternating two week roster.

   The role of the team leader is:

• To perform the Primary Survey
• To supervise and communicate with team members performing Secondary Survey
• Communicate to all in resus room the plan for patients, after gathering relevant information.

• Provide direction with Secondary Survey or need for additional Surgical or Anaesthetic assistance.

2. ICU Registrar

   Responsile for airway management. Should remain with the intubated patient until final placement has been made. This includes visits to the CT scanner. Also responsible for allocating ICU beds in consultation with senior ICU staff.

3. Emergency Registrar

   Responsible for overall co-ordination, documentation and placement of patient. Assists with resuscitation in the primary and secondary survey. If the patient does not require admission, assumes overall care of the patient.

4. Surgical Registrar

   Along with the Resuscitation/Emergency Registrar is responsible for the detailed examination of the patient after the prirnary survey is completed and mobilisation of surgical resources. When experienced will make decisions regarding definitive management. Communicates with appropriate specialty teams.

5. Orthopaedic Registrar

   Carries trauma page whilst in the hospital. Attends all trauma alerts whilst in the hospital . Reviews trauma cases when requested whilst on call. This request should be made early in the patient's resuscitation.

6. Nursing Staff

   Three Registered Nurses should be present in the resuscitation room to receive the trauma patient. At the beginning of each shffl, 3 nurses wiU be aUocated for resuscitation by the NUM or delegate to attend all trauma calls. Their roles are:

• SENIOR NURSE: Prepares drugs and equipment for intubation. Assists with airway, C-Spine stabilisation and circulation requirements. Stationed at head of bed with resuscitation team leader.
• SECOND NURSE: Procedure nurse predominantly. May assist with the ABCs initially but prepares for all procedures eg. catheterisation, diagnostic peritoneal lavage, intercostal catheterisation, thoracotomy etc. May need assistance from senior nurse once ABCs are stable.
• THIRD NURSE: Documents all vital signs, fluids, procedures and medication administered.

   In major resuscitation, additional nursing assistance may be required to assist and act as runners where necessary. It will be the decision of the team leader nurse to caU for extra assistance. Wardsman should be available to act as runner and to collect and deliver blood. If the trauma is minor, two nurses will be stood down by the team leader once the ABC are stabilised. The nurse team leader will delegate the appropriate nurse to remain with the patient.

7. Paediatric Registrar

   Available for all paediatric trauma.

8. Wardsman

   Will attend trauma pages and facilitate transport until asked to stand down by the senior registered nurse. Also acts as runner for bloods equipment etc.

9. Radiographer

   Attends all trauma pages and positions the portable X-ray machine on the first call.

10. Social Worker

   Attends to family and friends to provide emotional support.

11. Pathology Department

   Informed of trauma in order that blood products and cross matching is facilitated.the patient's resuscitation.

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