#SimBlog: Trauma
"3-minute pre-alert. 16-year-old female hit by a van travelling in excess of 40mph. Knocked out at scene"
Currently: reduced GCS, breathing with output but not stable for MTC transfer. Scoop and run by EMAS.
Observations
A (+ c-spine) – Clear and self maintaining. C-spine not immobilised.
B – Rate 30, SpO2 91% on room air
C – Pulse 110, BP 100/40 Cap Refill >3
D – GCS 10, E3 V2 M5, pupils equal 3mm reactive to light, BM 5.5
E – Bruising and wound to head, bruising, wound and deformity to left thigh
Blood Results
WBC – 12.4
HGB – 120
pH – 7.34
PCO2 – 4.4
PO2 – 8.5 (venous sample)
Why We Simulated?
As part of the Major Trauma Network, Leicester is a Major Trauma unit. This means we will still see trauma come direct to us if there are critical ABC issues. This also means we will potentially still see the sickest traumas.
Regular practice ensures all members of the department are familiar with the management of trauma.
Learning Points
Identify team members role before patient arrives.
Largest cannula possible for trauma patients.
Consider catastrophic Haemorrhage in Trauma patients.
If evidence of catastrophic haemorrhage, activate Massive Transfusion protocol & consider Tranexamic acid.
Positive Feedback
Trauma call put out, NIC and EPIC informed.
Used pre-alert to collect trauma board and prepare bay.
Patient immobilised with collar and new trauma board, patient undressed.
A, B, C, D, E approach used, IV access and bloods taken including G & S and near patient testing.
Identified the need for urgent CT.
