Trauma

SJRHEM is a Level 1 Trauma Centre

 

Trauma Team:

A predefined group of physicians and staff who have pre-designated functions to ensure comprehensive and coordinated care of the major trauma patient, including:

  • Emergency Physician
  • Trauma Team Leader (TTL)
  • Surgical Specialists, as required
  • Non-surgical specialists, as required
  • Emergency RN(s)
  • Respiratory Therapist
  • Other Emergency Department Support Staff
  • Diagnostic Imaging Technologist (x-ray)

Trauma Team Activation

Trauma Team Activation (TTA) begins when the Trauma Team Leader (TTL) on call receives a trauma call based on predetermined criteria established by the NB Trauma Program (pre-hospital activation when possible). Notification of the TTL may come from:

  • The attending emergency physician or other consultant (for patients self-presenting to the SJRH or TMH ED, and for patients who may be initially seen by a consultant for single system injury, but who have more complex injuries than initially identified)
  • Ambulance NB (for local patients arriving via ambulance)
  • Trauma Control Physician (for inbound trauma transfers)

 

Level A Trauma Team Activation:

Level A Activation is reserved for the most seriously injured patients with imminent life or limb threatening problems. The TTL activates appropriate members who should attend the ED prior to patient arrival.

The TTL initiates a Level A TTA when a patient presents with any of the following:

  • Major injury to 2 or more body systems
  • Ongoing hemodynamic instability
  • Penetrating injuries to head, neck, chest, abdomen, groin or extremities proximal to elbow andknee
  • Flail chest
  • Burns with potential airway involvement
  • Severe maxillofacial injury with potential airway compromise
  • GCS < 9 and a second involved system
  • Simultaneous arrival of 3 or more multi-trauma patients
  • Discretion of Emergency physician/TTL

Level B Trauma Team Activation:

The TTL initiates a Level B TTA when a patient presents with any of the following:

  • Major injury to 1 body system
  • Hemodynamic instability at any point during resuscitation, currently stable
  • Combination trauma with burns > 20% BSA, no airway involvement
  • GCS < 14 and a second involved system
  • Hemorrhage with partial or total amputation
  • Pelvic fracture (determined clinically) that is hemodynamically stable
  • Amputation proximal to wrist and ankle
  • 2 or more proximal long bone fractures
  • Pregnant patients > 20 weeks with fetal distress and/or premature labour associated with significantmechanism of injury (MOI)
  • Discretion of Emergency Physician/TTL

NB Trauma and SJRHEM

Links to Clinical Practice Guidelines and SJRHEM representatives

NB Trauma Policy Documents – 2017 (Note contact NB Trauma directly for most up to date versions)

2 4-010 Trauma Team Activation- version 2 0

2.4-020 Trauma Team Roles and Responsibilities Policy – version 2.0