In the most recently published Victorian State Trauma Registry report, 39% of all trauma cases were transport related. Trauma prevention and road safety continues to play a huge part in the reduction of major trauma in Victoria and today we are joined by Samantha Cockfield, Head of Road Safety for the Transport Accident Commission (TAC) to provide insight into current issues facing Victorian road users and the role of the TAC. Current at date of publication 14/01/2021.

Victims of major trauma have a varied profile, including age, demographic & geographic location. Today Danielle speaks with Melissa Webb, trauma and orthopaedic allied health team leader at The Alfred Hospital to gain an understanding of the importance of a multidisciplinary approach to care and consider rehab and planning beginning from the roadside. Current at date of publication 04/01/2021.

Children are vulnerable to injury for a number of reasons with motor vehicle collisions (MVC'S) accounting for almost half of the fatalities in children. In Victoria, the Paediatric Infant Perinatal Emergency Retrieval (PIPER) service is available to retrieve critically injured children from referring hospitals and provide safe, expert, emergency inter-hospital care. Today we speak with Dr Sile Smith, a Paediatric Intensive Care Consultant from the Royal Children's Hospital and Medical Co-lead for PIPER about the role PIPER has in Paediatric Major Trauma. Current at date of publication 28/12/2020.

Emergency management of a difficult airway in the major trauma patient is always a daunting task. Complications may arise as a result of emergency intubations, but failure or delay in securing an adequate airway may contribute to unacceptably high morbidity and mortality rates. Today we are talking to Dr Peter Fritz, Consultant Emergency Physician at The Alfred Hospital about Airway Management in the trauma patient. Current at date of Publication 21/12/2020.

Early specialist care of Spinal Cord Injury (SCI) can have a significant effect on long-term outcomes for these patients. The natural progression of SCI, in particular rising spinal cord oedema, may lead to an exacerbation of symptoms in the hours following an accident. Today we speak with Associate Professor Andrew Nunn, Director of the Victorian Spinal Cord Services at Austin Health who provides insight into early management of the patient suffering a potential spinal injury. Current at date of publication 21/12/2020.

The Victorian State Trauma System is one of the best in the world, with Adult Retrieval Victoria playing a significant role in making this a success. Today Danielle talks with Dr David Anderson, Acting Medical Director of Ambulance Victoria and an Intensivist at The Alfred Hospital to discuss how Adult Retrieval Victoria (ARV) operates within the state trauma system and gives you an inside look into behind the scenes of coordinating the care and retrieval of a major trauma patient. Current at date of publication 7/12/2020.

Limbs can often be involved in traumatic injuries from accidents in the workplace or farming for example. They can have a devastating impact on not only the patient but on bystanders. Today Danielle speaks to Mr Andrew Oppy, Lead Orthopaedic Trauma Surgeon at the Royal Melbourne Hospital to discuss how to approach the trauma patient with a significant extremity injury and provides some great insight into management of the affected limb. Current at date of publication 26/10/2020.

As with all trauma care, an organised approach to patient assessment is essential: ensuring life threatening injuries are identified and the patient is stabilised is the priority. Facial injuries that are not affecting the airway or causing life threatening haemorrhage can be assessed as part of the secondary survey, no matter how disfiguring the injuries may appear. Today we are joined by Alf Nastri, Head of the Maxillofacial department at Royal Melbourne Hospital.

Thoracic trauma is a common injury in the multi-trauma patient and a significant cause of mortality. Life threatening injuries identified in the primary survey need to be addressed at the time before moving on to the secondary survey. In this episode Danielle is joined by Mr Phillip Antippa, Cardiothoracic surgeon and Head of the Thoracic Surgery Service at Royal Melbourne Hospital to discuss early identification & management of traumatic chest injuries

Early management of traumatic brain injury incorporates minimising secondary brain injury by avoiding periods of hypoxia, hypotension and applying management principles to support the injured brain. In this podcast we are joined by Prof Kate Drummond, Director of Neurosurgery at the Royal Melbourne Hospital to discuss one of the most common and significant causes of morbidity and mortality in Australia. Current at date of publication 08/08/2020. 

Trauma patients are predisposed to hypothermia for a variety of reasons including exposure to the environment and disordered homeostasis. Patients who remain hypothermic are at risk of developing serious sequalae such as acidosis and coagulopathy resulting in an increased risk of mortality.

Today we are chatting with Dr Sharyn Ireland, a Clinical Nurse Educator at The Alfred Emergency and Trauma Centre about early identification of the hypothermic patient, physiological effects of hypothermia and strategies to manage it in the major trauma patient. Current at date of publication 13/07/2020.

The time immediately after injury is crucial in the management of the trauma patient. The primary survey is designed to identify and treat life-threatening injuries quickly and is indicated for the evaluation of all trauma patients. In this podcast, Dr Jenny Jamieson, Emergency Medicine Consultant at The Alfred Hospital and Monash Medical Centre talks to us about the principles behind the Trauma Survey, including the Primary, Secondary & Tertiary assessment, with a focus on the initial identification and management of injuries. Current at date of publication 29/05/2020.

Identifying potential injuries of the spine of a trauma patient and choosing the best imaging modality to investigate these may be challenging to navigate, particularly where radiology services have limited availability and/or accessibility. Associate Professor Dinesh Varma, Director of Trauma and Emergency Radiology at The Alfred Hospital, talks us through how factors such as clinical assessment, and mechanism of injury can play a vital role in decision making for imaging, and tips on clearing the spine. Current at date of publication 14/05/2020.

Trauma patients are at high risk of developing Trauma Induced Coagulopathies; the patient sub-group already using prescribed oral anticoagulants for pre-existing illness are at an even greater risk of developing complications related to this. Dr Giles Kelsey, Consultant Haematologist at The Royal Melbourne Hospital and The Alfred Hospital talks to us about assessment, identification and management of bleeding patients from trauma with a particular focus on those on Oral Anticoagulant Medication. Current at date of publication 01/05/2020.

Debriefing after trauma is an important quality improvement process that allows the team as a whole to reflect on their performance after a high stakes clinical scenario. Dr Luke Phillips, an Emergency Physician at The Alfred Hospital talks to us about the principles of debriefing after a major trauma with a focus on "Hot Debriefing". Current at time of publication 05/03/2020.

The obstetric trauma patient presents as a complex scenario for all clinicians. We often get distracted by the unborn child, but foetal survival depends on effective maternal resuscitation. With the use of case studies, Dr Emma West – Consultant Emergency Physician at the Royal Melbourne Hospital, talks us through the initial assessment and management priorities of the pregnant major trauma patient. Current at date of publication 5/03/2020.

Blunt abdominal trauma makes up a significant proportion of traumatic injuries in Australia. Dr Joseph Matthew, from Alfred Hospital helps us to gain a better understanding of blunt force mechanisms & the impact of a shift to more conservative management approaches has seen on trauma outcomes.

Current at date of publication, 29/1/2020

Children are vulnerable to injury for a variety of reasons and trauma continues to be their leading cause of morbidity and mortality. Dr Claire Wilkin, Consultant Paediatric Emergency Physician joins us to talk through the challenges of managing a paediatric trauma patient and shares her experience, tips and tricks to assist clinicians the next time they care for a Paediatric Major Trauma.

Current at date of Publication 28/1/2020

This episode will get you thinking about intravenous fluid choices for when you are next managing a hypovolaemic trauma patient. Dr. John Dyett, an Intensive Care Specialist at Eastern Health & Retrieval Consultant at Adult Retrieval Victoria discusses the key principles of fluid resuscitation in the severely hypovolemic Major Trauma patient. John explains the aims for haemostatic resuscitation, rationales for blood product administration and how to prevent or modify the effects of the lethal triad.

Lifesaving pin hole surgery! Why, when, where, how, and who?

Dr Gerard Goh, Interventional Radiologist at Alfred Health, explains the role of Interventional radiology, a minimally invasive technique in the management of life threatening injuries in Major Trauma. Current at time of publication 30/10/2019.

The role of ultrasound has evolved over the past 30 years and now plays an important role in trauma care, both diagnostically & procedurally. In this episode Dr. Amaali Lokuge an Emergency Physician at the Royal Melbourne Hospital & Clinical Lead for Ultrasound talks us through how ultrasound has become an extension of her clinical practice with the rapid assessment and diagnosis of traumatic injuries. Current at date of publication; 13/08.

The exchange of clinical information is critical in reducing risk and prioritising care for the trauma patient. Dr Helen Stergiou an Emergency & Trauma Physician from Alfred Health explains why it is important to be prepared & use a structured approach to handover the clinical information & accountability across the patients care pathway. Current at date of publication; 06/08/2019.

Victorian State Trauma Outcomes Registry Monitoring Group (VSTORM) is a fundamental element of the Victorian State Trauma System. Dr Ben Beck the Deputy Head of Prehospital, Emergency & Trauma Research at Monash University joins us to explain VSTORM's role in monitoring system performance, informing service provision & development with an aim to reduce preventable deaths and permanent disability from major trauma. Current at date of publication;05/08/2019.

Yvonne Singer the Victorian Burns Program Coordinator has a wealth of knowledge when it comes to managing burns. In this episode Yvonne talks us through how current burns literature is guiding best practice, giving valuable tips to clinicians for assessing & managing major burns, and gives us an inside perspective of the Victorian Adults Burns Service, at the Alfred. Current at date of publication, 22/7/2019

Ambulance Victoria (AV) is often the first responder to a major traumatic incident. Ian Hunt, MICA Paramedic and Manager of the Emergency Management Unit explains how AV respond, coordinate & communicate in the event of a major trauma incident, whilst ensuring AV's normal business and service to the community has little interruption. If only there was a big red button. Current at date of publication; 09/07/2019. 

Managing patients and families psychological trauma is challenging & is often delayed as we are absorbed in the initial management and lifesaving treatment of a major trauma patient.

Connie Montagner joins us to explain why psychological trauma should not be forgotten and talks us through an easy to use framework to provide psychological first aid to our trauma patients, their families and ourselves. Current at date of publication; 09/07/2019.

Are you providing consistent burns care? Listen in as Toby St Clair, a MICA Flight Paramedic & Yvonne Singer the Victorian Burns Program Coordinator talk us through the initial management of burns. Toby discusses some of the challenges & priorities of pre-hospital burns management and provides a practical approach to their care. Yvonne provides us insight into the continuum of care on arrival to the Victorian Adult Burns service & management advice supported by burns literature. Current at date of publication; 11/06/2019.

A collaborative discussion with two passionate advocates for older people after major trauma, Dr Mya Cubitt, an Emergency Physician, and Dr. Kwang Lim, a Geriatrician. This discussion will highlight the complexities and challenges of caring for this patient group, which includes; physiological differences, initial assessment, management, systems and processes to ensure appropriate ongoing care. Current at date of publication; 13/05/2019.

Pre-hospital management of older trauma patients is challenging. James Marshall, Paramedic Educator with Ambulance Victoria, explains how physiological changes and co-morbidities complicate pre-hospital initial assessment and triage. James shares his own experiences and strategies to ensure optimal pre-hospital care for the older person trauma. Current at date of publication; 10/05/2019.

Did you know there are systems designed that send major trauma patients to the best hospital for their condition? The technology used gets patients to help in the most safe and timely manner.

Michael (Mick) Stephenson, Executive Director of Clinical Operations at Ambulance Victoria talks to us about the Ambulance Victoria response to major trauma patients. Mick describes activation systems that the initial 000 call will trigger to ensure an appropriate response; with extra consideration to ensure an accurate assessment, triage and management. Current at date of publication; 18/04/2019.

We chat with Dr. Jonathan Papson, the Director of Emergency Education at the Royal Melbourne Hospital, about the importance of teamwork and communication in managing major trauma. We discuss proven techniques for developing a functional team structure, using effective communication and demonstrate strategies to manage conflict. Jonathan also shares some of his own personal experiences in practice. Current at date of publication; 18/04/2019. 

Traumatic cardiac arrest can be a highly stressful scenario. Dr David Camilleri, an Emergency Physician and Retrieval Consultant, discusses cardiac arrest in the setting of major trauma. David explains the need for synthesis and preparation, a shared mental model and the benefits of guidelines so we can deliver the lifesaving treatment these patients require. Current at date of publication; 18/04/2019.

In this episode Professor Peter Cameron talks us through the history & development of the Victorian State Trauma System (VSTS) and the Trauma Guidelines . He explains how a state-wide approach, evidence base, robust planning, & ongoing monitoring drive continuous quality improvement, seeing the VSTS evolve as a world leading trauma system. Current at date of publication:18/04/2019.