Trauma Reflections – June 2017

Thanks to Dr. Andrew Lohoar and Sue Benjamin for leading the discussions this month



Major points of interest:


A) Activation improves resource accessibility

Trauma Team Activation is intended to give increased ability to request consultant services, diagnostic imaging, lab, access to inpatient beds, on the TTLs authority.

Be aware that by policy, we should have disposition resolved by 4 hours.

Issues with process can be documented on the TTA form. Every case is reviewed.


B) Time dependent injuries transferred to our ED

These cases should have enough lead time that the required surgical services can be on site on arrival. Please call consultants in advance with an ETA for patients.

C) Important not to miss steps in primary and secondary surveys, including eFAST

Occult injuries can be picked up more quickly with attention to detail.


D) EtOH can mask major injuries

Enough said.


E) Tranexamic acid administration

Ensure given within 3 hours for appropriate “potential” blood loss. (also see CRASH3 trial)


F) Pan Scan CTs/ C spine CT

Will pick up occult injuries which are otherwise potentially missed. Have a low threshold.


G) Trauma transfers for DI

These cases should come through ED for reassessment and not go direct to scanner.

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