On arrival at the emergency department, a structured handover is provided by the paramedics to the treating team, using the IMIST-AMBO format.5 The timing of the handover will be dependent on patient clinical stability and requirements. If the patient is stable, it may be best to perform the handover before placing the patient on a trolley. If the patient is unstable or critically unwell, it may be necessary for the patient to be transferred to the trolley so the team can continue management and intervention, while the team leader receives the handover.
The reception and resuscitation of major trauma patients involves simultaneous assessment and management, with multiple activities occurring in parallel. Resuscitation follows the standard ABCDE approach, with some modifications based on recognising and treating immediate life threats that are unique to trauma patients, and preventing secondary complications.
The response to resuscitation will vary depending on the injuries sustained, the treatment administered or omitted as well as other factors such as the patient’s age and medical comorbidities.
Ongoing resuscitation is guided by the response to treatment and the need for definitive management.
Assessment must also be made of medical conditions and comorbidities that may have preceded or contributed to the patient sustaining an injury, especially in in elderly patients. Cardiac or neurological events leading to syncope or falls are common events that predispose to injury in older patients.
Ensure the patient is correctly identified and appropriate patient identification labels applied.