Trauma guidelines
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The document outlines goals and expectations for a trauma guidelines program, including: - The primary goal is for residents to manage all admitted patients under the supervision of attending surgeons, acting as team leaders to coordinate care. - Additional goals are for residents to gain surgical knowledge through discussions with attendings and independent reading, and to gain operative skills through preparation and instruction in the operating room. - The guidelines aim to maximize survival of life-threatening injuries, minimize disability from potentially disabling injuries, and reduce pain and suffering.
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Trauma guidelines
- 2. GOALS & EXPECTATIONS Goals: Primary responsibility for the management of all patients admitted to or evaluated by the team in conjunction with the attending surgeon Functions as the team leader, assuming direct responsibility for day-to-day care of patients on the service and coordinating care with consulting services Gain knowledge of surgical care through discussion on rounds with the attending and by independent reading Gain operative skills through pre-operative reading and preparation and by direct intra-operative teaching from attendings
- 3. 1. Life-threatening injuries are appropriately treated, promptly and in accordance with appropriate priorities, so as to maximize the likelihood of survival. 2. Potentially disabling injuries are treated appropriately, so as to minimize functional impairment and to maximize the return to independence and to participation in community life. 3. Pain and psychological suffering are minimized.
- 4. Within these three broad categories, there are several specific medical goals that are eminently achievable within the resources available in most countries. Obstructed airways are opened and maintained before hypoxia leads to death or permanent disability. Impaired breathing is supported until the injured person is able to breathe adequately without assistance. Pneumothorax and haemothorax are promptly recognized and relieved. Bleeding (external or internal) is promptly stopped. Shock is recognized and treated with intravenous (IV) fluid replacement before irreversible consequences occur. The consequences of traumatic brain injury are lessened by timely decompression of space occupying lesions and by prevention of secondary brain injury. Intestinal and other abdominal injuries are promptly recognized and repaired. Potentially disabling extremity injuries are corrected. Potentially unstable spinal cord injuries are recognized and managed appropriately, including early immobilization. The consequences to the individual of injuries that result in physical impairment are minimized by appropriate rehabilitative services. Medications for the above services and for the minimization of pain are readily available when needed.