Early Activation

Pre-hospital services should notify the receiving hospital that a trauma patient is on their way. This information may be crucial to the management of 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.

Once notification has been received it is important to gather vital information from the notifier using the MIST mnemonic. (15, 16)

Mechanism of injury
Injuries found or suspected
Signs: respiratory rate, pulse, blood pressure, SpO2, GCS or AVPU
Treatment given
  1. Ensure all staff involved in patient care are wearing gloves, aprons, and eye protection. Personal protective equipment is vital in the care of trauma patients.
  2. Activate the trauma team and available support departments (medical imaging, pathology). In small health service settings this may only consist of two clinicians. 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.
  3. 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. Designate roles and specific tasks to staff and maintain an approach based on teamwork.
  4. Set up the receiving bay for the patient, including equipment checks, documentation, medications, and resuscitation equipment.
If it is anticipated that transfer to an MTS will be required, early retrieval activation is essential (phone ARV on 1300 368 661).

Early retrieval activation ensures access to critical care advice, a more effective retrieval response and timely critical care transfer which all aim to improve 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 an MTS as required.