Trauma 1 - S Leslie



This on-demand teaching session for medical professionals will cover trauma treatments in the emergency department. Attention will be paid to the ideal team model, with emphasis on proper communication, good leadership, and a systemic approach. Discussions will include ideal world scenarios, protocols for major trauma centers, and running a trauma team in smaller units. Overall, attendees will gain an understanding of the importance of rapid assessment and initiation of life-preserving treatments, as well as knowledge of how to establish the ideal trauma team in their own department.
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Learning objectives

Learning Objectives: 1. Identify the key components of a trauma team in an Emergency Department 2. Describe the roles and responsibilities of each member of a trauma team in an Emergency Department 3. Describe the benefits of systemizing the approach to trauma care in an Emergency Department 4. Recognize the importance of effective communication, leadership and teamwork when providing trauma care in an Emergency Department 5. Compare and contrast the components of the Royal College of Trauma Call Protocol with common practices in an Emergency Department setting.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.

don't worry. Yeah, maybe, uh, how you guys gonna run in here? Okay. And so it flows. Don't know. Maybe I'm Sarah of the consultants, and today I'm gonna talk to you Better trauma on the trauma tainment in the emergency department. And I'm going to talk about kind of ideal world stuff. So the dream team and trauma on hurry and ideal time should work. So other am names. A talker kind of talked about the importance of a team approach to trauma, good communication, good leadership, having a systemic approach to everything. And if you improve the confidence when you're part of the team, that team works better. And I have been part of manager on the teams of lad, right? If you have led them, wail led them bodily being part of teams at work way on ones that work badly on it really makes a difference to you. Come in a way and what you know from just highway lot team works together. Even if about, I come for the teams worked really well together. You'll come away from it with some sort of satisfaction on learning points from. So I'm going to be honest and tell him. Play Drazen. Both of the stroller manuals widely on did recommend. If you get just one at least courses you should do it. The 80 last course is definitely and more genuine members of the names. A PSA first course today. Definitely. Do it. And then if you're more senior, but look about more experience. The European trial, of course, is excellent. Really? Don't reinforce the importance of the time. Later on, the team approach Detrol. So if I was trying to summarize on one kind of sentence Nice guy, a long sentence name what the names of trauma Care Emergency department are. It's the rapid assessment of injuries on the initiation of life. Preserving therapy in a timely fashion with creaky critical decision makers involved, really, in order established, definitive care. Know what I mean is I want whenever you have a trauma coming in, you really do you want the right people in the room with you? You want somebody? He can decide whether that patients gonna go to theater, Whether we're going to go see t where they need intubated. Rather need some critical and procedures done right there. And then you do you want you don't know what's helpful in this. Lovely is the surgical after you might be. I don't want them there. I want their boss and I will person. He's gonna make a decision with me so we could be for it. And everything is quickly as possible In what age trauma. We use the term very broadly, and we used to describe a number of things. So from things like it's falling over and breaking a limb to multi car pileups with poly traumas. And so we use the term very widely, then northern and describe the door in the trauma network uses this kind of definition. I'm not gonna read our uti's going read it yourself and then again you can see it is quite long and there's a lot of different components to you. So we do use the term trauma to cover a lot of different things. And also, in the last couple of years, this term celebrate trauma has become a major part of our practice and certainly in the college. But that's something we do see a lot of on the college. You're very clean that we think about it. Um, I certainly changed my practice. And I think when you think about it available a person they can sing pelvic fractures from falling over from standin. They could break their necks from standing. And they are also quite often on the regular, insists conflict kid and Chest Andres. And they also medications that so their heart react on day have ah, higher normal. So still like BP. So if I come in in my heart races, a little pressure was 100 and 10. You wouldn't be worried. But if someone 85 has a story profession 100 times and not slow for them, so hes and the tame and he should You haven't attainment again. I'm gonna talk and ideal world here. So when you cut a trauma, call it and these are the people you want dying. I I d appreciate that we're in smaller unit and this is not the major trauma center for Northern Ireland. But I think if we have an appreciation of what the Big Teams day, we can try and work towards that and think it will weaken dated after our team to work that so looking at this diagram shows you just how many people can be involved. So your team leader and is a daily someone quite saying You're someone who's got a better background and trauma and somebody can confidently like that thing. They're gonna be the most important person and moving forward with your trauma care. And for a you're gonna have an airway dog, which, ideally, is in a experience to anesthetic doctor on, then a nurse. He can help them with what they want today. So the nurse again, he's got experience and an intubation. An assistant with that breathing doctor usually is a surgical doctor, so that someone he can put in chest reines or recognize that someone's got a pneumothorax or two teeth or cost me. That's where we get surgeons. But they have experience not on an inertia, a vein, your second, help them without two and then circulation and other. You know, it's just if someone was better orthopedic experience, they're gonna be involved. Getting 80 access taking bloods off assess in the abdomen and pelvis, the general long bone fractures, reducing the pen on pelvic splints and all those different types of thing and again, a nurse that can help them with up the most important person is gonna be describes. That's usually one of those senior nurses that will break doing everything that's going on. And I on the times looked all the drugs are given in what time, and that's a really difficult rule. And if anyone ever tried to appreciate hi Difficult, that is. And that's a really K. And if you give enough people someone he's involved in Transfusion Coordination's and their sole job is to with the major hammers protocols, pit I or calls. But I think you're gonna be coordinating the units as they come up, given them. Documented them times, keeping a track of everything if you have enough people or someone extra, actually, 100 cover runner. So someone that can run organize CT scans like a PCR, speak the family, Um, and then the silliest rations. Just really to show that if you think about it, one of our trauma be's I'm having. All these people in there is really busy and it's lied. There's everyone's a gentleman's pump, and you've got a stress pace, and it's gonna be lots going on. So that trauma team leader really need to try to stand on the top of the bed and get a hold of everything that's happened. Everything's happening to continue the and all of the same time you're also gonna have and trauma will you think people conducted a rubberneck? Almost. They want to come in and have a look at it, and it's really up to use time later or a similar to remember that if you're not needed in that environment, you need to get a you need to if you're not doing anything. If you're not, contribute and don't be, there won't be in the way because they're still march happen all the same time. The paramedics and we'll be there is well, and they'll cry often. They'll hang around and you'll want to Hungary because you wanted to ask questions and see if you think of anything we are on that you haven't been given with the hand over, you're gonna have to ask them to leave. They gonna have to be out somewhere else because it's just so busy. So just think of that environment. Think of how many people there is there. Think of the noise Just have here you need, unless you but make sure the people here they're know whether do that make sense? So again, Just gonna keep rewriting this so well. The trauma team All of a shared cool. Not Callisto. A dent If I entreat life threatening injuries, don't pay any other major problems. Arrange time, critical treatments, investigations on insurance for that patient, the defendant care and how liver So trauma team here. And it was really just getting this Surgeons dying. But if sex toys and call a adult pediatric of static trauma get your things doing and then the Northern Trust. When I looked up the Internet necessary, they kind of faint what they would expect. Just repetitive trauma team call for and again. It covers a whole heap of things, but it's ultimately that are teams decision in the department. If we want to trauma call eternal, then the next night it just shows what the royal pit Citroma call it for. I know I said, we're not the royal. I don't want to be like the royal way to work it for us. But if we know how I did a run up, just the major center weaken take tests from them on but it towards our came and again. They have quite a broad range here for their amber recalls, and then they're red. Trauma Call is essentially just team leader is concerned, or the pre hospital care because they were concerned that But I don't know tropical, so you're pretty alert is really important on a can. Either give you abundance of information or absolutely nothing at all, and the paler is only as good as the person receiving the call on the person given the coal. So if you're not really experiencing, take a peeler calls and try and see whatever this and worsen your nurse and stuff, take it, or when the senior doctors takes a peeler, see what information they're getting. Uh, because this could really make a difference in how you can prepare the tape. I unfortunately, quite often and for the body traumas, we will just get a call from omelets Control saying we're bringing something because the paramedics don't have that pain are they don't feel able to they can call on themselves. There's too much going on, so sometimes you have absolutely no informational or you just get, um, a little tip. It's in here and there, but not the whole picture. Try and get We can from that pre alert and that could help you prepare your tape. So when you get your peeler and the team leader really should start, introduce themselves. Get your team involved by not here we are finding what range of scales they have. So I usually start things like I'm Sara in the emergency Consultant on today. Can we go right and say, Hey, we are especially. We are. If you have someone there from anesthetics, I will be like a you comfortable Teo. Enter it. This person, If need beta, they say no. Then I'll ask them to fill in their senior same way with the doctor away. Like if they need a chance tree. And are you happy not to date up? If they're know I lost him to get someone more senior or someone who was that, um, scale to come and help us? And previously still, where Talbert's I think that's gonna eat with Coolidge. And but what I would say and the times a cold Remeron, mosques and shadings try and write somewhere are multiple places in your body, your knee, and I'm not rule. You're doing so quite often on the face shields you can, but you know you could. Sarah, Team leader or whatever you're doing just makes everything a lot more. And there was a response to be there when everyone was everyone else's data. Whenever you're prepared and if you have time to repair, just try and prepare for the worst case scenarios, and that's glass half full attitude. But if you feel prepare, you compare to feeling about have your traumatic very tough your college of blocks. If there's top of hemorrhage, get a lawyer and tourniquets goes hemostatic agent. So pillar blood bank and get your port is involved pre alert radiology and we don't always have a CT available here, so get them. And as quickly as we can get all the senior stuff that you can feel that are available to you because, he said, we don't see in your case decision makers. They're old time and then think of your potential procedures. So if their failure says there's chest trauma, get your chest rains. I you have to open the box. We just have them available. Your splints. You're burn pox, whatever you can argue and really on just make up process mailer for you and again and not not the oil. And, you know, just say this is Dave a similar pretty alert and check list that they have open their department and just says things like, controlled drug case. Find out where they are because you need them. And portable suction. Making sure you've got your oxygen. Sellinger on the battle, right? I see that when you are hopefully going to say here are off the theater than you're not fasting, right? Looking for that? Blankets and things just have all those things right. Like this makes makes you looks me there is a tape and makes everything and run of that more smells like. So the same rules and again I'm gonna go back to is that we're all working towards the same goal. And so you're monitored trauma safely on getting everything done. So ct than 30 minutes a daily damage control plan with them for a five definitive care than 60 minutes night. That all seems very quick that everything moves like latent during a trauma. And that's what we should be, Um, and for hands too high to get the best at you. come in for the patient. Communication again is K. So everyone lessons that mess time over new ones to get to lesson to the paramedics. Everyone needs to know what happened and what they have done. We are communicating box sitting leader, key information. Lay close communication lips on trying to use that for when you come, um, keeps everything nice and and somebody this were simple people on. We like everything straight forward and again. It's just this is a photo from the OTC manual, and it kind of it illustrates in the pathway to should go to the patient or a a uti a five second rinds. That's basics. Make sure they're not arrested and they're not Peri arrest that there's not something wildly different than what you were expecting. If there is, you have your skin plans and you work through that and then the horizontal approach to trauma just shows it. All these things are happening. The same pain. So your area says what your reading is s and circulation assessment. They're all happening at the same time. US team leader. I tend to give everyone kind of a couple of minutes and then started a and ask everyone toe work. Three. When you have that conversation with the onset of doctor or the airway doctor and they're saying that I think the patient needs or the patient needs interview, did the thing that's going to give you confidence stepped up. I'll run three b and C and then I'll go back up to A I will get that intervention down at that point and that keeping everything count and clack that is a good one and that hopefully someone speaking to say, Hey, we're going to take this 80 or whatever we need today Whole body CT in trauma is kind of really a school Saturn I and it is, I don't think Manny radiologist or Oregon without knowing if you feel a significant trauma, we're going to scan from head to pelvis. That's an adult only. And Children I know we still kind of already an isolated and dedicated image in sequences. But I didn't believe that paid are probably even more towards CT and especially a seating with all these air in last, radiation exposure is and gold and but currently whole body CT and trauma is shouldn't be an issue when I first started it the deadly starchy on. Say, why do you need everything building? But I think night amongst the Realogy colleagues. They're pretty how they just a CT Everything on. Then afterwards you just part of plan on. So it's where you're gonna discharge this patient to be on again at the train approach to ideally, when you're running that trauma you've got and the emergency physicians that anesthetic surgeons, a neuro come out with a plan together with more information from your, um, clinical examinations Come in. Your realistic goal examinations is I'm working on. So just to summarize what the team should be doing some communication is K so and the brief in the beginning. So you're pretty alert. You're gonna introduce every book they, um, and dress yourself and everybody and what your scales are on what you're capable of doing. And sure, everyone has two cm 80 of what the patient's condition is. So everyone should have you on the same page. Well, singing from the CME handshake, I would usually express a clear plan based on a pre alert. So if it's ah, traumatic, had Andre be like a patient going to come in we're gonna do your hands off, hand over. We're going to start. Our assessments were concerned about it Ahead and grace. So we're gonna look Teo, introduce her neuro protective and steps and then get the CT and then also have a plan B implant. See if I've got time to go through that list. That the tape so they might also have unopen chest one. They may also have broken pelvis and talks with those if you have the time. But clear national plans are important during the results. It a shin the team leader facilitates everything. So they I get the information that back to them and then go back to the team as needed. They said it's important that you meet ski information on keep this old clothes lip. And then after there's the day brief and part of the communication so and chantry with team what we did Well, what we did finally or what we could improve on on these out for Andre even get 13. Performance is situational. Awareness is really important during trauma and my talk. The URL tell you all the different things that could be happening to go on like a one on there so much going on. So it's really important. Everyone knows what's happening and the teams collective awareness of this comes to the team leader on the team leader is only as good as their team members, and they can only use information is given to them by their team members. All the members should be feel free to share freely. You should feel heard they should feel important on the TC quite nicely, says collected. Information needs to be interpreted by the team later to protect, impactful, majorly on the near future on provide direction when required. And this way, actions can be taken to avoid or me to get future problems. So all of it being aware what's going on? Arrange a so you can get really task focused when you're a team member, so you could be doing a dream. We also need to be a little bit aware that someone else is doing something or and what else could be going wrong. And then there's the authority. Great area. So where their eyes clear? Invisible leadership. Also, these make sure everyone feels important that everybody has ah boys and they feel empowered to use that voice feel in part to speak up, taking something for one wrong and because and the team leader, it's not a hand of the band and they're only really using information is being given to them. Whereas if you're the baby doctor or you're not seeing Dr you're there, you're next patient. You're touching them, you're seeing. I bother. Injuries are so if you're feeling that other team members aren't really taken onboard high serious, the windows are serious fractures, and you need to feel comfortable to voice that. I feel that you've been hurt, but with the C. In the meantime, if the team is a neck Spiriva starter, they're not the human. Well, that team, they don't need to take um or Thor it of leadership side. And I have seen that happen. Read Teenagers. There's been arguments between onset of doctor and the surgical doctor on. It's a team leaders job, Teo and Argument. And ultimately, their decision should be the one that is me a dosing for making forward. Okay, so I recently today and our Kim online larger module, and it was felt a quote after school after quote so stuck in, uh, one a blanket rate and respiration a kook to So everyone is moving forward together than success takes care of itself. That's literally Henry Ford and all members of the tape need you working towards a calm ghost about multiple times, and I got really important. And kids that remembers need to be involved are really as much as I love to see it. A disaster. Gasquet's. I didn't want them there and journal about trauma a day. We're gonna go to C T within 30 minutes, where if necessary, get them to theater and then dependent upon within lower. And that is the don't anyone. Any questions? Thanks very much, Sara. That was a really good grip. Eso again. If anyone's got any questions or comments, you want to pop into the chart function, we could bring this up. I really like that. It's like he had on team protein preparation that you've kind of brought from the royal for us. No things that sound like it. Adult here, Sharon, bring in Theresa's. So, yeah, um, absolutely. Am I? Well, definitely. Get some posters up on the board and get to have some. Um, memory is when you're getting ready just like what you need, All right. So doesn't seem to be any questions or comments, which hopefully it just means that's been really thoroughly covered. Just got so a not sure if Cream as available. Was he on here? He's been within the next talk.