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.
The following sequence of actions should take place upon initial notification:
- Gather vital information from the notifier using the IMIST mnemonic (7, 8):
Identification: Who and what is your role? Patient identifiers – name, age, sex.
Mechanism: Presenting problem, how it happened.
Injuries: specific injuries that have been found or potential to exist.
Signs: vital signs, such as HR, RR, BP, Temp, BGL, GCS, etc.
Treatment and Trends: treatment administered and patient’s response to
treatment, trends in vital signs.
- Set up the trauma bay to receive the patient, including equipment checks, documentation, medications, and resuscitation equipment.
- 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.
- Designation of roles and specific tasks to staff can help to maintain a structured approach based on teamwork. Ensure clear 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.
- 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.
If it is anticipated that transfer to a major trauma service will be required, early retrieval activation is essential, phone ARV on 1300 368 661.
- Early retrieval activation ensures access to critical care advice and a more effective and prompt retrieval response.
- Early activation and timely critical care transfer can significantly improve clinical outcomes for the patient (9).
If you are undecided, call the ARV coordinator, who can provide expert guidance and advice over the phone or via teleconference, and link to MTS as required.