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.