The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This early trauma care guideline provides evidence-based advice on the initial management and transfer of major trauma patients who present to Victorian health services with severe injuries.
This guideline is developed for all clinical staff involved in the care of trauma patients in Victoria. It is intended for use by frontline clinical staff that provide early care for major trauma patients; those working directly at the Major Trauma Service (MTS) as well as those working outside of a MTS.
These guidelines provide the user with accessible resources to effectively and confidently provide early care for critically injured patients. They provide up-to-date information for frontline healthcare clinicians. The guideline has followed the AGREE methodology for guideline development and is auspiced by the Victorian State Trauma Committee.
Clinical emphasis points
A trauma team approach with good communication, clearly understood roles and established clinical guidelines and practices is key to good trauma care.
The primary survey or initial assessment and management of a trauma patient are designed to detect and treat actual or imminent life threats and prevent complications from these injuries.
The main goal of early care is to ensure optimum resuscitation in the emergency setting as well as activation of the retrieval network, with timely transfer to an appropriate facility.
Avoidance of hypovolaemia in trauma is a cornerstone of management. A balanced approach to fluid replacement is important, especially in establishing early treatment goals.
The main goal of fluid resuscitation in trauma is preservation of vital organ function until bleeding can be controlled.
Avoid hypothermia in major trauma patients.
Adult Retrieval Victoria (ARV) is the first point of call to initiate retrieval and transfer in the adult patient.