Home

Major Trauma Guidelines & Education 

- Victorian State Trauma System

  • Home
  • Trauma System Guidelines
    • Trauma System Guidelines

      • Victorian Trauma System
      • Pre-Hospital Triage
      • Inter-Hospital Transfer
      • Preparation for Retrieval
      • Teamwork & Communication
      • Home
      • News
      • Learning Management System
      • Moderated Tutorials
      • Videos
      • Podcasts
      • Resources
      • App
      • Courses and Conferences
      • Links
      • Contact Us
      • Facebook
      • Twitter
  • Specialist Clinical Guidelines
    • Specialist Clinical Guidelines

      • Early Trauma Care
      • Burns
      • Obstetric Trauma
      • The Deteriorating Trauma Patient
      • Traumatic Brain Injury
      • Thoracic Trauma
      • Spinal Trauma
      • Anticoagulation in Trauma
      • Paediatric Trauma
      • Abdominal Trauma
      • Traumatic Cardiac Arrest
      • Imaging in Trauma
      • Older Person Trauma
      • Home
      • News
      • Learning Management System
      • Moderated Tutorials
      • Videos
      • Podcasts
      • Resources
      • App
      • Courses and Conferences
      • Links
      • Contact Us
      • Facebook
      • Twitter
  • Links & More
      • Home
      • News
      • Learning Management System
      • Moderated Tutorials
      • Videos
      • Podcasts
      • Resources
      • App
      • Courses and Conferences
      • Links
      • Contact Us
      • Facebook
      • Twitter
  • Contact Us
  • Facebook
  • Twitter

Search

  • Key Messages
    • Clinical emphasis points
  • Rapid Reference Guideline
    • Identification of Potential Major Trauma
      •  Vital signs
      •  Injuries found or suspected
      • Specialised trauma transfer indications
      •  High-risk criteria
    • Deterioration
      • Contact Retrieval Service
        • Telemedicine
        • Pre-transport communication and coordination
      • Retrieval and transfer
        • Ensuring patient readiness for transfer
      • References

        Rapid Reference Guideline

        CLICK ON IMAGE TO ENLARGE

         
        • Trauma System Guidelines
        • Victorian Trauma System
        • Pre-Hospital Triage
        • Inter-Hospital Transfer
        • Preparation for Retrieval
        • Teamwork and Communication
        • Specialist Clinical Guidelines
        • Early Trauma Care
        • Burns
        • Obstetric Trauma
        • The Deteriorating Trauma Patient
        • Traumatic Brain Injury
        • Spinal Trauma
        • Anticoagulation Trauma
        • Paediatric Trauma
        • Cardiac Arrest in Trauma
        • Imaging in Trauma
        • Older Person Trauma
        •  
        • Moderated Tutorials
        • APP
        • Podcasts
        • Videos
        • LMS
        • News
        • Links
        • Resources
        • Contact Us
        •  
        • Acknowledgements
        • Guideline Development
        • Login
        • Copyright
        • Disclaimer
        • Privacy
        • Contact Us
        • ©2021 Victorian Department of Health
        • Last Update: 15 January 2021
        • Trauma System Guidelines
          • Victorian Trauma System
            • Key Messages
              • Clinical emphasis points
            • Introduction
              • Definition of Major Trauma
                • Key features of the Victorian State Trauma System
                  • Victorian State Trauma System Outcomes
                    • Resources
                      • References
                      • Pre-Hospital Triage
                        • Key Messages
                          • Clinical emphasis points
                        • Rapid Reference Guideline
                          • Identification of Potential Major Trauma
                            •  Vital signs
                            •  Injuries found or suspected
                            • Isolated head injury in older people
                            •  High-risk criteria
                          • On Scene
                            • Scene Time
                            • ARV Notification
                          • Transport Time
                            • Persisting hypovolaemic shock
                          • References
                          • Inter-Hospital Transfer
                            • Key Messages
                              • Clinical emphasis points
                            • Rapid Reference Guideline
                              • Identification of Potential Major Trauma
                                •  Vital signs
                                •  Injuries found or suspected
                                • Specialised trauma transfer indications
                                •  High-risk criteria
                              • Deterioration
                                • Contact Retrieval Service
                                  • Telemedicine
                                  • Pre-transport communication and coordination
                                • Retrieval and transfer
                                  • Ensuring patient readiness for transfer
                                • References
                                • Preparation for Retrieval
                                  • Key Messages
                                    • Clinical emphasis points 
                                  • Rapid Reference Guide
                                    • Introduction
                                      • Retrieval Coordination
                                        • Choice of Transport Vehicle
                                          • Process of Transfer
                                            • Pre-transport communication and coordination
                                            • Ensuring patient readiness for transfer
                                          • Patient Preparation
                                            •  Airway
                                            •  Breathing
                                            •  Circulation and C-spine
                                            •  Documentation
                                            •  Alert
                                            • Other
                                          • References
                                          • Teamwork and Communication
                                            • Key Messages
                                              • Clinical emphasis points
                                            • Key attributes of an effective team
                                              • Trauma team structure
                                                • Trauma team positions
                                                • Modified trauma team positions
                                              • The role of the team leader
                                                • What is situational awareness?
                                              • Effective Communication
                                                • What is a shared mental model?
                                                • Briefing the team
                                                • Tacit vs explicit communication
                                                • Closed-loop communication
                                                • Handover
                                                • Remote support and communication
                                              • Dealing with issues
                                                • Graded assertiveness
                                                • Five-step advocacy
                                              • Trauma Team Training
                                                • References
                                              • Specialist Cinical Guidelines
                                                • Early Trauma Care
                                                  • Key Messages
                                                    • Clinical emphasis points
                                                  • Rapid Reference Guideline
                                                    • Introduction
                                                      • Early Activation
                                                        • Ambulance handover
                                                        • Reception and resuscitation
                                                      • Primary Survey
                                                        • Airway with cervical spine protection
                                                        •  Breathing and ventilation
                                                        •  Circulation with haemorrhage control
                                                        •  Disability
                                                        •  Exposure and environment
                                                      • Secondary Survey
                                                        • History
                                                        • Head-to-toe examination
                                                        • Head and face
                                                        • Neck
                                                        • Chest
                                                        • Abdomen
                                                        • Limbs
                                                        • Back
                                                        • Buttocks and perineum
                                                        • Genitalia
                                                      • Planning and Communication
                                                        • Early Management
                                                          • Airway management
                                                          • Fluid resuscitation
                                                          • Analgesia
                                                          • Fractures and dislocations
                                                          • Prevent hypothermia
                                                          • In-dwelling catheter
                                                          • Monitoring
                                                          • Glasgow Coma Scale
                                                          • Pathology tests
                                                          • X-ray or FAST scan
                                                          • Naso/orogastric tube (N/OGT)
                                                          • Wound care
                                                          • Tetanus immunisation
                                                          • Antibiotics
                                                          • Reassess
                                                        • Retrieval and Transfer
                                                          • References
                                                          • Burns
                                                            • Key Messages
                                                              • Clinical emphasis points:
                                                            • Rapid Reference Guideline
                                                              • Introduction
                                                                • Early Activation
                                                                  • Primary Survey
                                                                    •  Airway with cervical spine protection
                                                                    •  Breathing and ventilation
                                                                    •  Circulation with haemorrhage control
                                                                    •  Disability: neurological status
                                                                    •  Exposure/environmental control
                                                                  • Secondary Survey
                                                                    • History
                                                                    • Head-to-toe examination
                                                                    • Measuring burns
                                                                    • Head-to-toe examination
                                                                  • Planning and Communication
                                                                    • Early Management
                                                                      • Airway management
                                                                      • Fluid resuscitation
                                                                      • Compartment Syndrome
                                                                      • Analgesia
                                                                      • Wound care
                                                                      • Minimise heat loss
                                                                      • In-dwelling catheter
                                                                      • Monitoring
                                                                      • Glasgow Coma Scale
                                                                      • Pathology tests
                                                                      • X-ray/FAST scan
                                                                      • Naso/orogastric tube (N/OGT)
                                                                      • Tetanus immunisation
                                                                      • Antibiotics
                                                                      • Reassess
                                                                    • Retrieval and Transfer
                                                                      • References
                                                                      • Obstetric Trauma
                                                                        • Key Messages
                                                                          •  Clinical emphasis points
                                                                        • Rapid Reference Guideline
                                                                          • Introduction
                                                                            • Changes in pregnancy
                                                                            • Complications associated with trauma
                                                                          • Early Activation
                                                                            • Primary Survey
                                                                              •  Airway with cervical spine protection
                                                                              •  Breathing and ventilation
                                                                              •  Circulation with haemorrhage control
                                                                              •  Disability: neurological status
                                                                              •  Exposure/environmental control
                                                                            • Secondary Survey
                                                                              • History
                                                                              • Head-to-toe examination
                                                                            • Planning and Communication
                                                                              • Pre-hospital triage
                                                                              • Inter-hospital transfer
                                                                            • Early Management
                                                                              • Patient positioning
                                                                              • Airway management
                                                                              • Radiology
                                                                              • Pathology tests
                                                                              • Preventing hypothermia
                                                                              • Analgesia and antiemetics
                                                                              • Sedation
                                                                              • Monitoring
                                                                              • Wound care
                                                                              • In-dwelling catheter
                                                                              • Nasogastric tube
                                                                              • Tetanus prophylaxis
                                                                              • Antibiotics
                                                                              • Cardiac arrest
                                                                              • Blood matters
                                                                              • Reassess
                                                                            • Retrieval and Transfer
                                                                              • References
                                                                              • The Deteriorating Trauma Patient
                                                                                • Key Messages
                                                                                  • Clinical emphasis points
                                                                                • Rapid Reference Guideline
                                                                                  • Introduction
                                                                                    • Deteriorating trauma patients
                                                                                    • Track and Trigger
                                                                                  • Clinical Observation of Major Trauma Patient
                                                                                    • Recognising and responding to clinical deterioration
                                                                                  • Team Role in Recognising Deterioration
                                                                                    • ABCDEFG for deteriorating patients
                                                                                  • Early Activation or Consultation
                                                                                    • Further Information
                                                                                      • References
                                                                                      • Traumatic Brain Injury
                                                                                        • Key Messages
                                                                                          • Clinical emphasis points
                                                                                        • Rapid Reference Guideline
                                                                                          • Introduction
                                                                                            • Early Activation
                                                                                              • Primary Survey
                                                                                                •  Airway with cervical spine protection
                                                                                                •  Breathing and ventilation
                                                                                                •  Circulation with haemorrhage control
                                                                                                •  Disability: neurological status
                                                                                                •  Exposure/environmental control
                                                                                              • Secondary Survey
                                                                                                • History
                                                                                                • Neurological assessment
                                                                                                • Head-to-toe examination
                                                                                              • Planning and Communication
                                                                                                • Indications for ARV consultation and/or transfer to a major trauma service
                                                                                              • Early Management
                                                                                                • Airway management
                                                                                                • Imaging
                                                                                                • The intoxicated patient with head trauma
                                                                                                • Anticoagulation and head trauma
                                                                                                • Patient positioning
                                                                                                • Seizure Prophylaxis
                                                                                                • Pathology tests
                                                                                                • Thermoregulation
                                                                                                • Analgesia
                                                                                                • Sedation
                                                                                                • Monitoring
                                                                                                • Wound care
                                                                                                • In-dwelling catheter
                                                                                                • Nasogastric tube
                                                                                                • Tetanus immunisation
                                                                                                • Antibiotics
                                                                                                • Steroids
                                                                                                • Reassess
                                                                                              • The Rapidly Deteriorating TBI Patient
                                                                                                • Additional management points
                                                                                                • Hyperventilation
                                                                                                • Osmotherapy
                                                                                                • Burr hole evacuation
                                                                                              • Retrieval and Transfer
                                                                                                • References
                                                                                                • Spinal Trauma
                                                                                                  • Key Messages
                                                                                                    • Clinical emphasis points
                                                                                                  • Rapid Reference Guideline
                                                                                                    • Introduction
                                                                                                      • Early Activation
                                                                                                        • Early rapid neurological assessment
                                                                                                          • Primary Survey
                                                                                                            •  Airway with cervical spine protection
                                                                                                            •  Breathing and ventilation
                                                                                                            •  Circulation with haemorrhage control
                                                                                                            •  Disability: neurological status
                                                                                                            •  Exposure/environmental control
                                                                                                          • Secondary Survey
                                                                                                            • History
                                                                                                            • Head-to-toe examination
                                                                                                            • Neck
                                                                                                            • Chest
                                                                                                            • Abdomen
                                                                                                            • Limbs
                                                                                                            • Back
                                                                                                            • Buttocks and perineum
                                                                                                            • Genitalia
                                                                                                          • Planning and Communication
                                                                                                            • Early Management
                                                                                                              • Airway management
                                                                                                              • Fluid resuscitation
                                                                                                              • Monitoring
                                                                                                              • Medical imaging
                                                                                                              • Wound care
                                                                                                              • Pressure area care
                                                                                                              • Analgesia
                                                                                                              • Prevent hypothermia
                                                                                                              • Glasgow Coma Scale
                                                                                                              • Pathology
                                                                                                              • In-dwelling catheter
                                                                                                              • Nasogastric tube
                                                                                                              • Antibiotics
                                                                                                              • Reassess
                                                                                                              • Other
                                                                                                            • Retrieval and Transfer
                                                                                                              • Isolated spinal cord injury
                                                                                                              • Potential multi-trauma
                                                                                                            • References
                                                                                                            • Thoracic Trauma
                                                                                                              • Key Messages
                                                                                                                • Clinical Emphasis Points
                                                                                                              • Rapid Reference Guideline
                                                                                                                • Introduction
                                                                                                                  • Immediately life threatening injuries
                                                                                                                    • Tension pneumothorax
                                                                                                                    • Massive Haemothorax
                                                                                                                    • Cardiac Tamponade
                                                                                                                    • Open pneumothorax
                                                                                                                    • Flail Chest & Pulmonary Contusions
                                                                                                                    • Major tracheobronchial injuries – larynx/ trachea
                                                                                                                  • Early activation
                                                                                                                    • Primary survey
                                                                                                                      • Airway with cervical spine protection 
                                                                                                                      • Breathing and Ventilation
                                                                                                                      • Circulation with haemorrhage control
                                                                                                                      • Disability: Neurological status
                                                                                                                      • Exposure and environmental control
                                                                                                                      • Investigations
                                                                                                                      • Analgesia
                                                                                                                    • Secondary survey
                                                                                                                      • History
                                                                                                                      • Head-to-toe examination
                                                                                                                    • Planning and Communication
                                                                                                                      • Early management
                                                                                                                        • Airway management
                                                                                                                        • Fluid resuscitation
                                                                                                                        • Monitor
                                                                                                                        • Administer
                                                                                                                        • Wound Care
                                                                                                                      • Retrieval and Transfer
                                                                                                                        • References
                                                                                                                        • Anticoagulation in Trauma
                                                                                                                          • Key Messages
                                                                                                                            • Clinical Emphasis Points
                                                                                                                          • Rapid Reference Guideline
                                                                                                                            • Introduction
                                                                                                                              • Types of Oral Anticoagulation
                                                                                                                                • Vitamin K Antagonists
                                                                                                                                • Direct (or Novel) Oral Anticoagulants (DOAC’s/NOAC’s)
                                                                                                                                • Half-life and Elimination
                                                                                                                              • Monitoring and Pathology Tests
                                                                                                                                • Interpretation of coagulation screen
                                                                                                                              • Management Agents
                                                                                                                                • Transfusion support
                                                                                                                                • Anti-fibrinolytic agents
                                                                                                                                • Pro-haemostatic agents
                                                                                                                                • Reversal agents
                                                                                                                              • Early Management
                                                                                                                                • Head Injury and Oral Anticoagulants
                                                                                                                                  • Retrieval and Transfer
                                                                                                                                    • References
                                                                                                                                    • Paediatric Trauma
                                                                                                                                      • Key Messages
                                                                                                                                        • Clinical emphasis points
                                                                                                                                      • Rapid Reference Guideline
                                                                                                                                        • Introduction
                                                                                                                                          • Early Activation
                                                                                                                                            • Primary Survey and Early Management
                                                                                                                                              •  Airway with cervical spine protection
                                                                                                                                              •  Breathing and ventilation
                                                                                                                                              •  Circulation with haemorrhage control
                                                                                                                                              •  Disability: neurological status
                                                                                                                                              •  Exposure/environmental control
                                                                                                                                            • Secondary Survey
                                                                                                                                              • History
                                                                                                                                              • Neurological exam
                                                                                                                                              • Head-to-toe examination
                                                                                                                                            • Additional points for early management
                                                                                                                                              • Trauma imaging
                                                                                                                                              • Analgesia
                                                                                                                                              • In-dwelling catheter
                                                                                                                                              • Orogastric tube (OGT)
                                                                                                                                              • Antibiotics
                                                                                                                                              • Tetanus immunisation
                                                                                                                                              • Reassess
                                                                                                                                            • Planning and Communication
                                                                                                                                              • Paediatric Burns Sub Guideline
                                                                                                                                                • Overview
                                                                                                                                                • Assessment
                                                                                                                                                • Management
                                                                                                                                              • Paediatric Spinal Sub Guideline
                                                                                                                                                • Overview
                                                                                                                                                • Assessment
                                                                                                                                                • Management
                                                                                                                                              • Paediatric Traumatic Brain Injury Sub-Guideline
                                                                                                                                                • Overview
                                                                                                                                                • Advice and Retrieval
                                                                                                                                                • Primary Survey Assessment
                                                                                                                                                • Management
                                                                                                                                                • CT scanning
                                                                                                                                              • Retrieval and Transfer
                                                                                                                                                • References
                                                                                                                                                • Abdominal Trauma
                                                                                                                                                  • Key Messages
                                                                                                                                                    • Clinical Emphasis Points
                                                                                                                                                  • Rapid Reference Guideline
                                                                                                                                                    • Introduction
                                                                                                                                                      • Blunt abdominal trauma
                                                                                                                                                      • Angioembolisation
                                                                                                                                                      • Penetrating abdominal trauma
                                                                                                                                                      • Solid organ versus hollow viscus injury
                                                                                                                                                    • Early Activation
                                                                                                                                                      • Primary Survey
                                                                                                                                                        • Airway with cervical spine protection 
                                                                                                                                                        • Breathing and ventilation 
                                                                                                                                                        • Circulation with haemorrhage control 
                                                                                                                                                        • Disability: Neurological status 
                                                                                                                                                        • Exposure and environment 
                                                                                                                                                        • Emergency Laparotomy
                                                                                                                                                        • Imaging
                                                                                                                                                      • Secondary Survey
                                                                                                                                                        • History
                                                                                                                                                        • Head-to-toe examination
                                                                                                                                                      • Planning and Communication
                                                                                                                                                        • Early Management
                                                                                                                                                          • Haemostatic resuscitation
                                                                                                                                                          • Permissive hypotension
                                                                                                                                                          • Damage control surgery
                                                                                                                                                          • Naso/orogastric tube (N/OGT)
                                                                                                                                                          • Urinalysis
                                                                                                                                                          • Imaging
                                                                                                                                                          • Blunt trauma
                                                                                                                                                          • Penetrating wounds
                                                                                                                                                          • Laboratory tests
                                                                                                                                                          • Fluid resuscitation
                                                                                                                                                          • Analgesia
                                                                                                                                                          • Prevent hypothermia
                                                                                                                                                          • Monitoring
                                                                                                                                                          • Glasgow Coma Scale
                                                                                                                                                          • Tetanus immunisation
                                                                                                                                                          • Antibiotics
                                                                                                                                                          • Reassess
                                                                                                                                                        • Retrieval and Transfer
                                                                                                                                                          • References
                                                                                                                                                          • Traumatic Cardiac Arrest
                                                                                                                                                            • Key Messages
                                                                                                                                                              • Clinical Emphasis Points:
                                                                                                                                                            • Rapid Reference Guideline
                                                                                                                                                              • Introduction
                                                                                                                                                                • Pre-hospital considerations
                                                                                                                                                                  • Management
                                                                                                                                                                    • Haemorrhage
                                                                                                                                                                    • Tension pneumothorax
                                                                                                                                                                    • Airway obstruction
                                                                                                                                                                  • Conventional BLS and ALS considerations
                                                                                                                                                                    • External chest compressions & ventilation
                                                                                                                                                                    • Adrenaline
                                                                                                                                                                    • Defibrillation
                                                                                                                                                                    • Reversible causes
                                                                                                                                                                  • Resuscitation procedures
                                                                                                                                                                    • Ultrasonography
                                                                                                                                                                    • Pericardiocentesis
                                                                                                                                                                    • Resuscitative Thoracotomy
                                                                                                                                                                  • Resource Limited Facility
                                                                                                                                                                    • Return of Spontaneous Circulation ROSC
                                                                                                                                                                      • Damage control resuscitation
                                                                                                                                                                    • Endpoint to Resuscitation
                                                                                                                                                                      • Debriefing
                                                                                                                                                                        • Paediatric Considerations
                                                                                                                                                                          • References
                                                                                                                                                                          • Imaging in Trauma
                                                                                                                                                                            • Key Messages
                                                                                                                                                                              • Clinical Emphasis Points:
                                                                                                                                                                            • Introduction
                                                                                                                                                                              • Modalities of Imaging
                                                                                                                                                                                • Plain film X-rays
                                                                                                                                                                                • Ultrasound
                                                                                                                                                                                • CT scanning
                                                                                                                                                                                • MRI
                                                                                                                                                                              • Early Activation
                                                                                                                                                                                • Indications for Imaging
                                                                                                                                                                                  • Head
                                                                                                                                                                                  • Spine
                                                                                                                                                                                  • Chest
                                                                                                                                                                                  • Abdomen
                                                                                                                                                                                • Radiation and contrast considerations
                                                                                                                                                                                  • Paediatric considerations
                                                                                                                                                                                    • Trauma imaging
                                                                                                                                                                                  • Education Modules
                                                                                                                                                                                    • Adult
                                                                                                                                                                                    • Paediatric
                                                                                                                                                                                  • References
                                                                                                                                                                                  • Older Person Trauma
                                                                                                                                                                                    • Key Messages
                                                                                                                                                                                      • Clinical Emphasis Points
                                                                                                                                                                                    • Rapid Reference Guideline
                                                                                                                                                                                      • Introduction
                                                                                                                                                                                        • Older person Anatomy and Physiology
                                                                                                                                                                                        • Mechanism of Injury
                                                                                                                                                                                      • Early Activation
                                                                                                                                                                                        • Primary Survey
                                                                                                                                                                                          • Airway with cervical spine protection 
                                                                                                                                                                                          • Breathing and ventilation 
                                                                                                                                                                                          • Circulation with haemorrhage control 
                                                                                                                                                                                          • Disability: neurological status 
                                                                                                                                                                                          • Exposure/Environmental Control 
                                                                                                                                                                                        • Secondary Survey
                                                                                                                                                                                          • History
                                                                                                                                                                                          • Head-to-toe examination
                                                                                                                                                                                        • Planning and Communication
                                                                                                                                                                                          • Limitation of Treatment Orders
                                                                                                                                                                                            • Early Management
                                                                                                                                                                                              • Diagnostic imaging
                                                                                                                                                                                              • ECG
                                                                                                                                                                                              • Optimising oxygenation
                                                                                                                                                                                              • Fluid resuscitation
                                                                                                                                                                                              • Insert
                                                                                                                                                                                              • Monitor
                                                                                                                                                                                              • Administer
                                                                                                                                                                                              • Monitor blood results
                                                                                                                                                                                              • Wound Care
                                                                                                                                                                                              • Psychological health
                                                                                                                                                                                            • Transfer and Retrieval
                                                                                                                                                                                              • References
                                                                                                                                                                                              • Home
                                                                                                                                                                                              • News
                                                                                                                                                                                              • Learning Management System
                                                                                                                                                                                              • Moderated Tutorials
                                                                                                                                                                                              • Videos
                                                                                                                                                                                              • Podcasts
                                                                                                                                                                                              • Resources
                                                                                                                                                                                              • App
                                                                                                                                                                                              • Courses and Conferences
                                                                                                                                                                                              • Links
                                                                                                                                                                                              • Contact Us
                                                                                                                                                                                              • Facebook
                                                                                                                                                                                              • Twitter