Trauma Handbook

Table of Contents with Links

Mission Statement / Introduction

Overview of Trauma Service

• Contact Information
• Telephone Numbers
• Trauma Service Protocols Overview

The Resuscitation Room

• Trauma page and Trauma Team Activation
• Transfers
• Trauma Bypass
• Operating Room Resuscitation
• BSI/Universal Precautions

Initial Assessment and Resuscitation

• Resuscitation Room Coordination
• Obtaining Blood samples
• Ordering Blood units
• Massive Transfusion Protocol
• Request form for Emergency Blood
• MIVT Report
• Responsibilities of Team Members
• Physicians Orders in Resuscitation Room
• Resuscitation Room Lab Investigations
• Radiology
• Organ Injury Scale
• Radiology Request Form
• Non-Operative Management of Major Trauma

Airway with C-Spine Control

• Airway Management
• King LTA and EOTA Airways
• CMAC Video Laryngoscope
• Esophageal Tube Introducer
• Rapid Sequence Intubation Protocol

Head Injuries

• Clinical Guideline for Traumatic Brain Injury
• ICP monitoring
• Treatment of Increased ICP
• Adjunctive Medications and Prevention of Complications
• Surgical management of TBI
• Intracranial Hypertension Management

Reversal of Anticoagulation

• Trauma patient on anticoagulation with CHI
• Blood product and Factor Algorithm - not on warfarin
• Interpreting Thromboelastograms (TEG)
• Thromboelastography
• Patient on Anticoagulant or Antiplatelets
• Guideline to Emergent Bleeding Reversal
• Factor Algorithm for life-threatening bleeding due to Warfarin

Concussion Screening

• Acute Concussion Evaluation
• Concussion Return to Play Protocol
• Current Concepts in Concussion

C-Spine Workup and Management

• C-Spine evaluation - awake and alert
• C-Spine evaluation - unreliable, altered

Neck Trauma

• Blunt neck trauma
• Blunt Cerebrovascular Screening
• Denver BCVI Grading Scale

Penetrating Neck trauma

• Penetrating Neck Wound - Exploration Zones
• Esophageal Injury
• Penetrating Neck Wound Algorithm
• WTA Penetrating Neck Wound Algorithm

Facial fractures

• Facial Fractures without CHI
• Facial Fractures with Mild CHI

Chest Trauma

• Non-op Management Chest Trauma

Blunt Chest Trauma

• Blunt chest trauma algorithm
• Chest tube insertion/removal
• Rib fracture management protocol

Penetrating Chest Trauma

• Penetrating Chest Injuries Algorithm - Stable
• Penetrating Chest Injuries Algorithm - Unstable

Retained Hemothorax

Abdominal Trauma

• Blunt Abdominal Trauma
• Non-op Management of Liver injury
• Operative Management of Liver injury
• Non-op Liver Injury Algorithm
• Non-op Splenic Injury management
• Operative Splenic Injury management
• Stab Wound Abdomen management
• Zones of Abdomen and Diaphragm Injury
• Pancreatic Injury
• Pancreatic injury Algorithm
• Non-op management of Renal Injuries
• Operative Management of Renal Injuries
• Renal Injury on CT Scan Algorithm
• Zone II Retroperitoneal Hemotoma in OR

Pelvic Fractures

• Pelvic Fracture Algorithm
• T-POD Application

REBOA Protocol

• Indications
• REBOA Aortic Zones
• ER-REBOA Quick Reference Guide

Ultrasound

• Enhanced FAST Ultrasound
• Positive FAST Images
• FATE Limited Echo

Peripheral Vascular Injury and Compartment Syndrome

• Extremity Vascular injury algorithm
• Mangled Extremity Algorithm

Consulting Services

• Neurosurgery
• Plastic Surgery / Head and Neck Surgery
• Hand Surgery
• Orthopedic Surgery
• Orthopedic Procedures on Head Injured patients
• Guideline for Orthopedic Procedures on TBI patients

Service Responsibilities

• Tertiary Survey of Trauma Patients
• Handoffs /I-PASS
• I-PASS card
• Brief Operative Note
• Trauma deaths
• Reporting Deaths and Complications for M&M conference
• Discharge planning
• Trauma Clinic Follow-up
• Trauma patient phone call algorithm
• Acute Surgery/White Surgery Phone Call Algorithm
• Phone Calls Routed to Clinic Coordinators

Burns

• Lund & Browder Burn Area Chart

Pediatric Trauma

• Pediatric Trauma Hemodynamics
• Approach to child with multiple injuries
• Pediatric Transfer Considerations
• Classification of Hemorrhagic Shock in Pediatric Trauma
• Drugs used in Pediatric ALS

Venous Thromboembolism prophylaxis

• VTE Risk Stratification
• VTE prophylactic measures
• IVC Filter Candidates
• Summary of Trauma VTE Protocol
• VTE Risk factors
• VTE Prophylaxis Notes
• Weight-based Lovenox dosing
• Enoxaparin Guidelines in Special Populations

Surgical Critical Care

• ICU Nurse-led rounding
• mFASTHUGGs / RASS Score
• Talking to SICU Families / Family meetings
• Indications for Howell Service Consult
• Universal Upset Patient Protocol
• Initiation of Mechanical Ventilation
• Discontinuation of Mechanical Ventilation
• Ventilator STEER protocol
• Ventilator Extubation Protocol
• Extubation Algorithm
• Additional notes - Extubation
• Timing of Tracheostomy
• Anemia and Transfusion in Stable patients
• Brain Death Protocol
• Central Venous Catheter Insertion
• Antibiotics & Antifungals in Trauma/SICU patients
• Guideline for Antibiotic Duration
• Guideline for Stress Ulcer Prophylaxis
• Nutrition Notes
• NPO Guidelines for Preop patients
• Nutritional on-hold unexpectedly Guideline
• Pain-Agitation-Delirium-Guideline
• Confusion-Assessment Method in ICU (CAM-ICU)
• Guideline for Hypertonic Saline

Disaster Planning

• Health System Codes
• Ten Predictable Surprises in Disasters
• Functional Areas / Teams
• Disaster Treatment Record (Paper)
• Chemical, Biological, Radiological Terrorism
• Radiologic Weapons
• Potential Biologic Agents
• Potential Chemical Agents
• Acute Radiation Syndrome
• Burn Surge Plan
  

Acute Care Surgery

• Appendicitis - Uncomplicated
• Appendicitis - Complicated
• Acute Diverticulitis
• Acute Calculous Cholecystitis
• Suspected necrotizing fasciitis
  

Video Links