Victorian State Trauma System
Trauma System Guidelines
▼
Victorian Trauma System
▼
Key Messages
▼
Clinical Emphasis Points
Introduction
Definition of Major Trauma
Key features of the Victorian State Trauma System
Victorian State Trauma System Outcomes
Resources
References
Pre-Hospital Triage
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guide
Identification of Potential Major Trauma
▼
Vital Signs
Injuries found or suspected
Isolated head injury in older people
High-risk criteria
On Scene
▼
Scene Time
Retrieval Service Notification
Transport Time
▼
Persisting hypovolaemic shock
References
Inter-Hospital Transfer
▼
Key Message
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
▼
Vital Signs
Injuries Found or Suspected
Specialised Trauma Transfer Indications
High Risk Criteria
Deterioration
Contact Retrieval Service
▼
Telemedicine
Pre-transport communication and coordination
Retrieval and transfer
▼
Ensuring patient readiness for transfer
References
Preparation for Retrieval
▼
Key Messages
▼
Clinical emphasis points
Rapid Reference Guide
Introduction
▼
Coordination
Movement ‘up the chain of care’
Need for retrieval systems
Retrieval Coordination
Choice of Transport Vehicle
Process of Transfer
▼
Pre-transport communication and coordination
Ensuring patient readiness for transfer
Patient Preparation
▼
Airway
Breathing
Circulation
Documentation
Alert
Other
References
Teamwork & Communication
▼
Key Messages
▼
Clinical Emphasis Points
Introduction
Trauma team structure
▼
Trauma team positions
Modified trauma team positions
The role of the team leader
Zero-Point Survey
Effective Communication
Dealing with issues
Trauma Team Training
References
Specialist Clinical Guidelines
▼
Early Trauma Care
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
▼
Ambulance Handover
Reception and Resuscitation
Primary Survey
▼
Catastrophic Haemorrhage
Airway with Cervical Spine Protection
Breathing and ventilation
Circulation with haemorrhage control
Disability
Exposure and environment
Secondary Survey
▼
History
Head-to-toe examination
Neurological assessment
Head and Face
Neck
Abdomen
Limbs
Buttocks and perineum
Genitalia
Planning and Communication
Early Management
▼
Airway management
Fluid resuscitation
Tranexamic Acid (TXA)
Analgesia
Fractures and dislocations
Prevent hypothermia
In-dwelling catheter
Monitoring
Pathology tests
X-ray or eFAST scan
Naso/orogastric tube (N/OGT)
Wound Care
Tetanus immunisation
Antibiotics
Reassess
Retrieval and Transfer
References
Burns
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey
▼
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure/environmental control
Secondary Survey
▼
History
Head to Toe Examination
Measuring Burns
Planning and Communication
Early Management
▼
Airway Management
Fluid Resuscitation
Compartment Syndrome
Analgesia
Wound Care
Minimise Heat Loss
In-dwelling Catheter
Monitoring
Glasgow Coma Scale
Pathology Tests
X-ray/FAST scan
Naso/orogastric tube (N/OGT)
Tetanus Immunisation
Antibiotics
Reassess
Retrieval and Transfer
References
Obstetric Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey
Secondary Survey OB
Planning and Communication
▼
Pre-hospital triage
Inter-hospital transfer
Early Management
▼
Patient Positioning
Airway Management
Radiology
Pathology Tests
Preventing Hypothermia
Analgesia and Antiemetic
Sedation
Monitoring
Wound Care
In-dwelling Catheter
Nasogastric Tube
Tetanus Prophylaxis
Antibiotics
Cardiac Arrest
Blood Matters
Reassess
Retrieval and Transfer
References
The Deteriorating Trauma Patient
▼
Key Messages
▼
Clinical Emphasis Points
Introduction
Clinical Observation of Major Trauma Patient
▼
Recognising and responding to clinical deterioration
Team Role in Recognising Deterioration
▼
ABCDEFG for deteriorating patients
Early Activation or Consultation
Further Information
References
Traumatic Brain Injury
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey
▼
Catastrophic Haemorrhage
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure and environmental
Secondary Survey
▼
History
Head to Toe Examination
Neurological Assessment
Head and Face
Neck
Chest
Abdomen
Limbs
Back
Planning and Communication
▼
Indications for ARV consultation and / or transfer to a major trauma service
Early Management
▼
Airway Management
CT scan/x-ray/FAST
Tranexamic Acid (TXA)
The intoxicated patient with head trauma
Anticoagulation and head trauma
Patient positioning
Seizure Prophylaxis
Pathology tests
Thermoregulation
Analgesia
Sedation
Monitoring
Wound care
In-dwelling catheter
Nasogastric tube
Tetanus immunisation
Antibiotics
Steroids
Reassess
Additional management points for the rapidly deteriorating patient
Hyperventilation
Osmotherapy
Burr hole evacuation
Retrieval and Transfer
References
Thoracic Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Immediately life threatening injuries
▼
Tension Pneumothorax
Massive Haemothorax
Cardiac Tamponade
Open Pneumothorax
Flail Chest Pulmonary Contusions
Major Tracheobronchial Injuries Larynx Trachea
Simple Pneumothorax
Diaphragm Injury
Blunt Aortic Injury
Oesophageal Injury
Early activation
Primary Survey
▼
Airway with Cervical Spine Protection
Breathing and Ventilation
Circulation with Haemorrhage Control
Disability
Exposure and Environmental Control
Investigations
Analgesia
Secondary Survey
▼
History
Head to Toe Examination
Spinal Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Early rapid neurological assessment
Primary Survey
▼
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure/environmental control
Secondary Survey
▼
History
Head-to-toe examination
Neck
Abdomen
Limbs
Back
Buttocks and perineum
Genitalia
Planning and Communication
Early Management
▼
Airway management
Fluid resuscitation
Monitoring
Medical imaging
Wound care
Pressure area care
Analgesia
Prevent hypothermia
Glasgow Coma Scale
Pathology
In-dwelling catheter
Nasogastric tube
Antibiotics
Reassess
Other
Retrieval and Transfer
▼
Isolated spinal cord injury
Potential multi-trauma
References
Anticoagulation in Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Types of Oral Anticoagulation
▼
Vitamin K Antagonists
Direct (or Novel) Oral Anticoagulants (DOACs/NOACs)
Half-life and Elimination
Monitoring and Pathology Tests
▼
Interpretation of coagulation screen
Management Agents
▼
Transfusion support
Anti-fibrinolytic agents
Pro-haemostatic agents
Reversal agents
Early Management
Head Injury and Oral Anticoagulants
Retrieval and Transfer
References
Paediatric Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey and Early Management
▼
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure/environmental control
Secondary Survey
▼
History
Neurological exam
Head-to-toe examination
Additional points for early management
▼
Trauma imaging
Analgesia
In-dwelling catheter
Orogastric tube (OGT)
Antibiotics
Tetanus immunisation
Reassess
Planning and Communication
Paediatric Burns Sub Guideline
▼
Overview
Assessment
Management
Paediatric Spinal Sub Guideline
▼
Overview
Assessment
Management
Paediatric Traumatic Brain Injury Sub-Guideline
▼
Overview
Advice and Retrieval
Primary Survey Assessment
Management
CT Scanning
Retrieval and Transfer
References
Abdominal Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
▼
Blunt abdominal trauma
Angioembolisation
Penetrating abdominal trauma
Solid organ versus hollow viscus injury
Early Activation
Primary Survey
▼
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: Neurological status
Exposure and environment
Secondary Survey
▼
History
Head-to-toe examination
Planning and Communication
Early Management
▼
Haemostatic Resuscitation
Permissive Hypotension
Damage Control Surgery
Naso/Orogastric Tube (N/OGT)
Urinalysis
Imaging
Blunt Trauma
Penetrating Wounds
Laboratory Tests
Fluid Resuscitation
Analgesia
Prevent Hypothermia
Monitoring
Glasgow Coma Scale
Tetanus Immunisation
Antibiotics
Reassess
Retrieval and Transfer
References
Traumatic Cardiac Arrest
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Pre-hospital considerations
Management
▼
Haemorrhage
Tension pneumothorax
Airway obstruction
Conventional BLS and ALS considerations
▼
External chest compressions & ventilation
Adrenaline
Defibrillation
Reversible causes
Resuscitation procedures
▼
Ultrasonography
Pericardiocentesis
Resuscitative Thoracotomy
Resource Limited Facility
Return of Spontaneous Circulation ROSC
▼
Damage control resuscitation
Endpoint to Resuscitation
Debriefing
Paediatric Considerations
References
Imaging in Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Introduction
Modalities of Imaging
▼
Plain film X-rays
Ultrasound
CT scanning
MRI
Early Activation
Indications for Imaging
▼
Head
Spine
Chest
Abdomen
Radiation and contrast considerations
Paediatric considerations
▼
Trauma imaging
Education Modules
▼
Adult
Paediatric
References
Older Person Trauma
▼
Key Messages
▼
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
▼
Anatomical and Physiological changes with ageing
Mechanism of Injury
Early Activation
Primary Survey
▼
Airway
Breathing
Circulation
Disability
Exposure/Environmental Control
Secondary Survey
▼
History
Head-to-toe examination
Planning and Communication
Limitation of Treatment Orders
Early Management
▼
Diagnostic imaging
ECG
Optimising oxygenation
Volume Replacement
Insert
Monitor
Administer
Monitor blood results
Wound Care
Psychological health
Transfer and Retrieval
References
LMS
Resources
Moderated Tutorials
Videos
Links
News
Contact Us
Trauma System Guidelines
Victorian Trauma System
Key Messages
Clinical Emphasis Points
Introduction
Definition of Major Trauma
Key features of the Victorian State Trauma System
Victorian State Trauma System Outcomes
Resources
References
Pre-Hospital Triage
Key Messages
Clinical Emphasis Points
Rapid Reference Guide
Identification of Potential Major Trauma
Vital Signs
Injuries found or suspected
Isolated head injury in older people
High-risk criteria
On Scene
Scene Time
Retrieval Service Notification
Transport Time
Persisting hypovolaemic shock
References
Inter-Hospital Transfer
Key Message
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Vital Signs
Injuries Found or Suspected
Specialised Trauma Transfer Indications
High Risk Criteria
Deterioration
Contact Retrieval Service
Telemedicine
Pre-transport communication and coordination
Retrieval and transfer
Ensuring patient readiness for transfer
References
Preparation for Retrieval
Key Messages
Clinical emphasis points
Rapid Reference Guide
Introduction
Coordination
Movement ‘up the chain of care’
Need for retrieval systems
Retrieval Coordination
Choice of Transport Vehicle
Process of Transfer
Pre-transport communication and coordination
Ensuring patient readiness for transfer
Patient Preparation
Airway
Breathing
Circulation
Documentation
Alert
Other
References
Teamwork & Communication
Key Messages
Clinical Emphasis Points
Introduction
Trauma team structure
Trauma team positions
Modified trauma team positions
The role of the team leader
Zero-Point Survey
Effective Communication
Dealing with issues
Trauma Team Training
References
Specialist Clinical Guidelines
Early Trauma Care
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Ambulance Handover
Reception and Resuscitation
Primary Survey
Catastrophic Haemorrhage
Airway with Cervical Spine Protection
Breathing and ventilation
Circulation with haemorrhage control
Disability
Exposure and environment
Secondary Survey
History
Head-to-toe examination
Neurological assessment
Head and Face
Neck
Abdomen
Limbs
Buttocks and perineum
Genitalia
Planning and Communication
Early Management
Airway management
Fluid resuscitation
Tranexamic Acid (TXA)
Analgesia
Fractures and dislocations
Prevent hypothermia
In-dwelling catheter
Monitoring
Pathology tests
X-ray or eFAST scan
Naso/orogastric tube (N/OGT)
Wound Care
Tetanus immunisation
Antibiotics
Reassess
Retrieval and Transfer
References
Burns
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure/environmental control
Secondary Survey
History
Head to Toe Examination
Measuring Burns
Planning and Communication
Early Management
Airway Management
Fluid Resuscitation
Compartment Syndrome
Analgesia
Wound Care
Minimise Heat Loss
In-dwelling Catheter
Monitoring
Glasgow Coma Scale
Pathology Tests
X-ray/FAST scan
Naso/orogastric tube (N/OGT)
Tetanus Immunisation
Antibiotics
Reassess
Retrieval and Transfer
References
Obstetric Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey
Secondary Survey OB
Planning and Communication
Pre-hospital triage
Inter-hospital transfer
Early Management
Patient Positioning
Airway Management
Radiology
Pathology Tests
Preventing Hypothermia
Analgesia and Antiemetic
Sedation
Monitoring
Wound Care
In-dwelling Catheter
Nasogastric Tube
Tetanus Prophylaxis
Antibiotics
Cardiac Arrest
Blood Matters
Reassess
Retrieval and Transfer
References
The Deteriorating Trauma Patient
Key Messages
Clinical Emphasis Points
Introduction
Clinical Observation of Major Trauma Patient
Recognising and responding to clinical deterioration
Team Role in Recognising Deterioration
ABCDEFG for deteriorating patients
Early Activation or Consultation
Further Information
References
Traumatic Brain Injury
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey
Catastrophic Haemorrhage
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure and environmental
Secondary Survey
History
Head to Toe Examination
Neurological Assessment
Head and Face
Neck
Chest
Abdomen
Limbs
Back
Planning and Communication
Indications for ARV consultation and / or transfer to a major trauma service
Early Management
Airway Management
CT scan/x-ray/FAST
Tranexamic Acid (TXA)
The intoxicated patient with head trauma
Anticoagulation and head trauma
Patient positioning
Seizure Prophylaxis
Pathology tests
Thermoregulation
Analgesia
Sedation
Monitoring
Wound care
In-dwelling catheter
Nasogastric tube
Tetanus immunisation
Antibiotics
Steroids
Reassess
Additional management points for the rapidly deteriorating patient
Hyperventilation
Osmotherapy
Burr hole evacuation
Retrieval and Transfer
References
Thoracic Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Immediately life threatening injuries
Tension Pneumothorax
Massive Haemothorax
Cardiac Tamponade
Open Pneumothorax
Flail Chest Pulmonary Contusions
Major Tracheobronchial Injuries Larynx Trachea
Simple Pneumothorax
Diaphragm Injury
Blunt Aortic Injury
Oesophageal Injury
Early activation
Primary Survey
Airway with Cervical Spine Protection
Breathing and Ventilation
Circulation with Haemorrhage Control
Disability
Exposure and Environmental Control
Investigations
Analgesia
Secondary Survey
History
Head to Toe Examination
Spinal Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Early rapid neurological assessment
Primary Survey
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure/environmental control
Secondary Survey
History
Head-to-toe examination
Neck
Abdomen
Limbs
Back
Buttocks and perineum
Genitalia
Planning and Communication
Early Management
Airway management
Fluid resuscitation
Monitoring
Medical imaging
Wound care
Pressure area care
Analgesia
Prevent hypothermia
Glasgow Coma Scale
Pathology
In-dwelling catheter
Nasogastric tube
Antibiotics
Reassess
Other
Retrieval and Transfer
Isolated spinal cord injury
Potential multi-trauma
References
Anticoagulation in Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Types of Oral Anticoagulation
Vitamin K Antagonists
Direct (or Novel) Oral Anticoagulants (DOACs/NOACs)
Half-life and Elimination
Monitoring and Pathology Tests
Interpretation of coagulation screen
Management Agents
Transfusion support
Anti-fibrinolytic agents
Pro-haemostatic agents
Reversal agents
Early Management
Head Injury and Oral Anticoagulants
Retrieval and Transfer
References
Paediatric Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Early Activation
Primary Survey and Early Management
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: neurological status
Exposure/environmental control
Secondary Survey
History
Neurological exam
Head-to-toe examination
Additional points for early management
Trauma imaging
Analgesia
In-dwelling catheter
Orogastric tube (OGT)
Antibiotics
Tetanus immunisation
Reassess
Planning and Communication
Paediatric Burns Sub Guideline
Overview
Assessment
Management
Paediatric Spinal Sub Guideline
Overview
Assessment
Management
Paediatric Traumatic Brain Injury Sub-Guideline
Overview
Advice and Retrieval
Primary Survey Assessment
Management
CT Scanning
Retrieval and Transfer
References
Abdominal Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Blunt abdominal trauma
Angioembolisation
Penetrating abdominal trauma
Solid organ versus hollow viscus injury
Early Activation
Primary Survey
Airway with cervical spine protection
Breathing and ventilation
Circulation with haemorrhage control
Disability: Neurological status
Exposure and environment
Secondary Survey
History
Head-to-toe examination
Planning and Communication
Early Management
Haemostatic Resuscitation
Permissive Hypotension
Damage Control Surgery
Naso/Orogastric Tube (N/OGT)
Urinalysis
Imaging
Blunt Trauma
Penetrating Wounds
Laboratory Tests
Fluid Resuscitation
Analgesia
Prevent Hypothermia
Monitoring
Glasgow Coma Scale
Tetanus Immunisation
Antibiotics
Reassess
Retrieval and Transfer
References
Traumatic Cardiac Arrest
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Pre-hospital considerations
Management
Haemorrhage
Tension pneumothorax
Airway obstruction
Conventional BLS and ALS considerations
External chest compressions & ventilation
Adrenaline
Defibrillation
Reversible causes
Resuscitation procedures
Ultrasonography
Pericardiocentesis
Resuscitative Thoracotomy
Resource Limited Facility
Return of Spontaneous Circulation ROSC
Damage control resuscitation
Endpoint to Resuscitation
Debriefing
Paediatric Considerations
References
Imaging in Trauma
Key Messages
Clinical Emphasis Points
Introduction
Modalities of Imaging
Plain film X-rays
Ultrasound
CT scanning
MRI
Early Activation
Indications for Imaging
Head
Spine
Chest
Abdomen
Radiation and contrast considerations
Paediatric considerations
Trauma imaging
Education Modules
Adult
Paediatric
References
Older Person Trauma
Key Messages
Clinical Emphasis Points
Rapid Reference Guideline
Introduction
Anatomical and Physiological changes with ageing
Mechanism of Injury
Early Activation
Primary Survey
Airway
Breathing
Circulation
Disability
Exposure/Environmental Control
Secondary Survey
History
Head-to-toe examination
Planning and Communication
Limitation of Treatment Orders
Early Management
Diagnostic imaging
ECG
Optimising oxygenation
Volume Replacement
Insert
Monitor
Administer
Monitor blood results
Wound Care
Psychological health
Transfer and Retrieval
References
LMS
Resources
Moderated Tutorials
Videos
Links
News
Contact Us
Major Trauma Guidelines & Education – Victorian State Trauma System
Learning Management System
Contact Us
Resources
LMS
Contact
Resources
Resources
Teamwork and Communication Guideline PDF
Download PDF
All Resources
Trauma Victoria Guideline PDF
Infusion Guideline Adult Retrieval Victoria
Online Learning Management System User Guide
Guideline Implementation
Trauma Victoria Posters
Reset
Guideline Implementation
Poster – Initial Management of Severe Burns
Download PDF
Poster – Victorian State Burns Referral Criteria
Download PDF
Early Trauma Care Rapid Reference Guideline
Download PDF
Inter-Hospital Transfer Rapid Reference Guideline
Download PDF
Pre-Hospital Triage Rapid Reference Guideline
Download PDF
Traumatic Brain Injury Rapid Reference Guideline
Download PDF
Obstetric Trauma Guideline Rapid Reference Guideline
Download PDF
Preparation for Retrieval and Transfer Rapid Reference
Download PDF
Spinal Trauma Rapid Reference Guideline
Download PDF