Key Messages

The Victorian State Trauma System (VSTS) 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 II methodology for guideline development and is under the auspice of the Victorian State Trauma Committee (VSTC).¹

Clinical emphasis points

• A trauma team approach with a focus on communication, role delegation and implementation of clinical guidelines and practices is key to good trauma care.
• Primary survey or initial assessment and management of a trauma patient is used to detect and treat actual or imminent life threats and prevent complications from these injuries.
• Optimising resuscitation in the emergency setting and early notification to the retrieval network helps to promote timely transport to an appropriate facility.
• A balanced approach to fluid resuscitation in trauma leads to preservation of vital organ function until bleeding can be controlled.
• Adequate temperature control with avoidance of hypothermia is essential in major trauma patients.
• Titrated narcotic analgesia is the initial approach to pain management in trauma.
• Adult Retrieval Victoria (ARV) is the first point of call to initiate retrieval and transfer in the adult trauma patient.