The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This deteriorating trauma patient 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 ongoing care and monitoring for deterioration in 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 Victorian State Trauma Committee (VSTC).¹

Clinical emphasis points

Early identification and management of deterioration in trauma patients follows the same principles as in any clinical setting:

• Early identification of potentially life-threatening problems, particularly those that are readily reversible, may be life-saving.
• Deterioration in a trauma patient is a complex matrix of identified and potentially unrecognised injuries.
• Established and implemented approaches currently in use provide a framework for evaluating and managing deteriorating patients.
• Careful monitoring of trauma patients with close attention to and documentation of vital signs is necessary to identify those at risk.
• A structured approach is required for recognising and managing life threats in trauma patients.