Early Activation
Emergency medical 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 mnemonic4:
Mechanism of injury
Injuries found or suspected
Signs: respiratory rate, pulse, blood pressure, SpO2, GCS or AVPU
Treatment given
- 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.
- Activate the trauma team and available support departments (medical imaging, pathology). In small health service settings this may only consist of a clinician and a nurse. 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.
- 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.
- Set up the trauma bay to receive the patient, including equipment checks, documentation, medications and resuscitation equipment.
Personal protective equipment is vital in the care of trauma patients. Ensure all staff involved in patient care are wearing gloves, aprons and eye protection.
If it is anticipated that transfer to an MTS will be required, early retrieval activation is essential (phone Adult Retrieval Victoria (ARV) on 1300 368 661).
- Early retrieval activation ensures access to critical care advice and a more effective retrieval response.
- Early activation and timely critical care transfer improves 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.