Early Activation

Emergency medical services responding to the scene will notify ARV and the receiving hospital that a trauma patient is on their way. This may be a major, metropolitan or regional trauma service or an urgent care centre, depending on distance, facilities available and the patient’s condition. Notification information may be crucial to managing the severely injured patient and can allow for communication to vital members of the response team as well as time to prepare the department for the patient’s arrival.

The following sequence of actions should take place upon initial notification:

1.  Gather vital information from the notifier using the MIST mnemonic:
    Mechanism of injury
    Injuries found or suspected
    Signs: respiratory rate, pulse, blood pressure, SpO2, GCS or AVPU
    Treatment given
    
2. PPE is vital in the care of trauma patients. Ensure all staff involved in patient care are wearing gloves, aprons and eye protection.
    
3. Activate the trauma team and available support departments (medical imaging, pathology). In small health service settings this may only consist of a clinician and a nurse. Additional staff may be gathered from wards or on call. It may be necessary to utilise the skills of all available resources including emergency response personnel in the initial trauma management.
    
4. Set up the trauma bay to receive the patient, including equipment checks, documentation, medications and resuscitation equipment.
    
5. Designate roles and specific tasks to staff and maintain an approach based on teamwork. Ensure good communication between all parties involved in managing the trauma. Use closed-loop communication, which ensures accuracy in information shared between response staff. Repeat instructions, make eye contact and provide feedback. Misinterpreted information may lead to adverse events.

 
If there is no prior notification of the patient, then rapid activation of the trauma team request must take place and any additional resources notified. If it is anticipated that transfer to a MTS will be required, early retrieval activation is essential (phone ARV on 1300 368661).

• Early retrieval activation ensures access to critical care advice and a more effective retrieval response.
• Early activation and timely critical care transfer improves clinical outcomes for the patient.

If you are undecided, call the ARV coordinator, who can provide expert guidance and advice over the phone or via tele/videoconference and link to a MTS as required.