The care of the trauma patient evolves over their admission with the focus on the delivery of treatments specific to the traumatic injury as well as preparing for the journey to recovery. The care of the trauma patient on the ward often involves a multidisciplinary team including medical and nursing staff, physiotherapists, occupational therapists, social workers, psychologists and dieticians. Often the care decisions are complex due to multiple medical teams looking after multiple injuries.
The patient’s condition can change over time with deterioration due to recognised complications such as pneumonia, thrombosis and delirium. Specific complications from inadequately treated pain or treatments (intercostal catheters) need to be actively sought and considered.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Immersive scenario
This resource kit provides participants with the knowledge and skill to manage a patient who has respiratory deterioration in the setting of chest trauma on the ward.
Duration: 45 minutes
Target Audience: Ward medical and nursing clinicians
Procedural skill
This resource kit provides clinicians with knowledge and skills for the care of a patient who requires a semi-rigid cervical collar for management.
Duration: 30 minutes
Target Audience: Ward medical and nursing clinicians
This resource kit provides procedural skill experience for the performance of log rolling with spinal precautions in the ward care setting following trauma.
Duration: 15-30 minutes
Target Audience: Ward medical and nursing clinicians
Case discussion
This resource kit provides the learner with knowledge for the choice and use of thoracic bracing with spinal column injury.
Duration: 30 minutes
Target Audience: Ward medical and nursing clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of ward trauma care.
Videos
Clinical resources
Trauma teams may vary in composition but rely on a shared mental model for effective patient care. Often in the ED environment, a trauma team is comprised of multidisciplinary clinicians of varying expertise who may or may not be familiar with the clinical strengths and capabilities of each team member. It is essential therefore, that the team leader has the skills and strategies for effective communication, to create a shared mental model and outline the aims in the management of each trauma patient.
Trauma team training is focused on the development of these skills, to empower team leadership and team membership to work as a unit, often by the use of simulation scenarios. It is a powerful training opportunity to allow all members of the multidisciplinary team to gain a deeper understanding of medical expertise, but also focus on effective means of communication within a complex team structure.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
This resource kit provides information to give the opportunity for the learner to explore and understand the priority assessment features during the trauma primary survey to identify serious injury.
This can be done as a pause and discuss exercise, multidisciplinary scenarios or as didactic education depending on the facilitator and participant need.
Duration: 30-45 minutes
Target Audience: Emergency department medical and nursing clinicians
Immersive scenario
This resource kit highlights the assessment and initial management of a patient with intraabdominal haemorrhage post trauma.
Duration: 45 minutes
Target Audience: Emergency department medical and nursing clinicians
This resource kit focusses on the use of a pre-brief, role allocation and effective teamwork strategies to care for a critically unwell trauma patient.
Duration: 45 minutes
Target Audience: Emergency department medical and nursing clinicians
This resource kit provides an opportunity to explore the barriers and challenges in the movement of trauma patients rapidly to theatre who are hemodynamically unstable.
Duration: 45 minutes
Target Audience: Emergency department, anaesthetic and theatre medical and nursing clinicians
This resource kit provides healthcare clinicians with knowledge and skills to effectively manage a multidisciplinary trauma team.
Duration: 45 minutes
Target Audience: Emergency department medical and nursing clinicians
This resource kit provides the learners the opportunity to consider multiple shock states in the trauma patient.
Duration: 30-45 minutes
Target Audience: Emergency department medical and nursing clinicians
Case discussion
This resource kit provides participants the opportunity to explore the trauma team roles and effective communication strategies for patient care.
Duration: 30-45 minutes
Target Audience: Emergency department medical, nursing and allied health clinicians
This resource kit provides a training opportunity to discuss common trauma triage challenges.
Duration: 30 minutes
Target Audience: Emergency department nursing clinicians
Role play
This resource kit provides healthcare clinicians with the knowledge on how to effectively perform clinical handover in the setting of chest trauma.
Duration: 30 minutes
Target Audience: Emergency department medical and nursing clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of trauma teams.
Clinical guidelines
Clinical resources
Videos
Pre-hospital care delivery is an expanding area of medicine that involves the collaboration of multiple services including the ambulance, fire and police in addition to the medical and nursing teams working with the hospital system to deliver streamlined care.
The composition of these teams will vary depending on the patient’s needs, resources available and the location of the incident. In Queensland, Retrieval Services Queensland performs the medical coordination, tasking and telemedicine services across the state. RSQ engage and work alongside Queensland Ambulance Service to provide the resources needed at the scene.
The delivery of prehospital care involves the assessment, provision of analgesia, airway support, haemodynamic management and disposition decisions with highly skilled teams performing these tasks in often austere environments. When preparing a patient for retrieval a structured process is of benefit to ensure further safe transfer is undertaken.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Immersive scenario
This resource kit provides pre-hospital clinicians with the skills to assess and manage a patient with blunt chest and extremity injury following trauma.
Duration: 45-60 minutes
Target Audience: Pre-hospital / Retrieval / Rural and Remote clinicians
Case discussion
This resource kit provides clinicians with the knowledge and skills to prepare a patient for retrieval and transfer to another hospital.
Duration: 30 minutes.
Target Audience: Emergency department medical and nursing clinicians.
Procedural skill
This resource kit provides background knowledge in the preparation for transfer by a retrieval team.
Duration: 30 minutes
Target Audience: Emergency department medical and nursing clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Major pelvic injury occurs in up to 9% of blunt trauma presentations. It is complicated by significant other organ injury in 20% of patients who are multiply injured following high velocity trauma (Biffl et al. 2001).
Hemorrhage is a major life threat with pelvic trauma and occurs due to disruption of the arterial or venous system, or due to bleeding from the disrupted cancellous bone. Mortality remains high for those patients with haemodynamic and mechanical pelvic instability despite intervention (Eastridge et al. 2002), (White et al. 2008).
Management may include the use of pelvic binders, haemostatic resuscitation, surgical and interventional radiological haemorrhage control techniques (White et al. 2008), (Coccolini et al. 2017).
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Immersive scenario
This resource kit provides healthcare workers with the knowledge and skills to manage a patient with an open book pelvic injury who is haemodynamically unstable following a traumatic incident.
Duration: 45-60 minutes.
Target Audience: Emergency department medical and nursing clinicians.
This resource kit provides healthcare workers with the knowledge and skills to manage a patient with an open book pelvic injury who is a transient responder following a traumatic incident.
Duration: 45-60 minutes.
Target Audience: Emergency medical and nursing clinicians.
Case discussion
This resource kit provides healthcare workers with knowledge of the clinical assessment and specific investigations required to identify and manage a patient suffering suspected pelvic trauma.
Duration: 45-60 minutes.
Target Audience: Emergency department medical and nursing clinicians.
This resource kit provides an opportunity to explore competing priorities in the trauma patient.
Duration: 30 minutes.
Target Audience: Emergency department medical and nursing clinicians.
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of pelvic trauma.
Clinical resources
Flowcharts
Videos
Paediatric trauma is trauma in children contrasts with anatomical, physiological and mechanism of injury differences compared to adults.
Injury mechanism changes depending on the age of the child, with infants at risk of rolling from change tables, pre-schoolers more likely to sustain falls and burns, school age children are at risk from sporting activities and playground equipment, and older children engaging in risk taking behaviours including self-harm and as a result of intoxication. All children are at risk from vehicular injury if incorrectly restrained, with land transport accidents comprising most deaths of children in 2022 in Australia (Australian Bureau of Statistics, 2022).
Anatomical differences are most pronounced in smaller children, for example they may sustain a significant pulmonary injury without external evidence of trauma given the thoracic bones compliance (Royal Children’s Hospital Melbourne, 2021). This is also important in how they respond physically to traumatic injuries, with a higher reliance on diaphragm movement for respiratory function in infants and the limited ability to increase tidal volumes to counteract pulmonary injury (Royal Children’s Hospital Melbourne, 2021).
Environments caring for paediatric patients should have readily accessible charts with age based vital signs and weight-based calculations of important medications to reduce potential errors and allow recognition of abnormalities.
Queensland Children’s Hospital is the only dedicated major trauma centre for children in Queensland. The QCH trauma service provides a consultatory service for approximately 900 trauma patients and their families every year from across Queensland and northern New South Wales (Children’s Health Queensland, 2021).
Other resources
Other resources and tools on the topic of paediatric trauma.
Clinical resources (QHealth access only)
Clinical assessment tools
Clinical guidelines
Courses
Trauma involving the neck and spine may occur following blunt and penetrating mechanisms. The neck and cervical spine are assessed during the primary survey to identify any life-threatening injury, identify patients in whom airway control is required and provide spinal precautions when indicated. Specific examination features include the use of the TWELVE-C assessment and consideration of investigations to delineate the injury- including plain Xray, CT scans, Ultrasound or MRI, as well as nasal fiberoptic examinations.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Immersive scenario
This resource kit provides the learner with the skills and knowledge to manage a patient with a suspected spinal cord injury.
Duration: 45 minutes, including debrief
Target Audience: Emergency department medical and nursing clinicians
Procedural skill
This skills session is to assess participants in assessment for neck injury following trauma utilising structured clinical format.
Duration: 15 minutes
Target Audience: Emergency department medical and nursing clinicians
Case discussion
This resource kit provides the learner with knowledge and skills in the clinical assessment of a patient with a possible cervical spine injury following trauma.
Duration: 30-45 minutes
Target Audience: Emergency department medical and nursing clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of neck and spinal trauma.
Clinical assessment tools
Clinical resources
Flowcharts
Patient information guides
Videos
The use of imaging modalities in trauma has evolved over recent years and provides rapid adjuncts to clinical assessment and management options for patient care. In the prehospital environment the use of point of care ultrasound has been widely adopted with the development of smaller handheld devices. Within the hospital setting, the early use of plain imaging using chest and pelvic X-Rays augments clinical examination and provides diagnostic information. The role of ultrasound, by performing an E-FAST (extended focussed assessment with sonography in trauma) is to identify the primary operative cavity in the hemodynamically unstable patient. In many centres computed tomography is routinely used to delineate injury profile and determine alternate treatment options including angioembolisation.
The decision to perform each imaging study will be based on factors including trauma mechanism, clinical stability, primary and secondary survey findings and access to the imaging resource. Clinicians should be aware of the use and limitations of each imaging modality within their clinical environment.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Case discussion
This resource kit provides an overview of chest trauma imaging interpretation including indications, complications of intervention and challenges in interpretation.
Duration: 30-60 minutes
Target audience: Trauma clinicians
This resource kit provides healthcare workers with an understanding of the role of imaging and interventional techniques utilised in the management of blunt abdominal trauma.
Duration: 30-45 minutes
Target audience: Emergency department medical and nursing clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of imaging in trauma.
Courses
Resuscitation in trauma is aimed at the replacement of volume and attention to the correction of coagulopathy. After the primary survey, an assessment is formulated to help determine if there is ongoing blood loss, or if the haemorrhage has now ceased but the patient still requires volume replacement.
This may be achieved in various ways across each location due to the resources available, the process for blood acquisition and storage, blood product delivery and patient need. The use of blood to expand the circulating volume after a haemorrhage should be in conjunction with adjuncts to improve the coagulation deficit to avoid inadvertent dilution due to only red cell replacement.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Procedural skill
This resource kit provides clinical staff the opportunity to practise the application and interpretation of a Viscoelastic haemostatic assay (VHA) trace (ROTEM) for the management of the bleeding trauma patient.
Duration: 30 minutes
Target Audience: Medical, nursing, and pharmacy clinicians
This resource kit provides an opportunity to discuss and practice the preparation for delivery of haemostatic resuscitation.
Duration: 30-40 minutes
Target Audience: Emergency department medical and nursing clinicians
This resource kit provides an opportunity for the learner to gain insight into escalation procedures and options for the management of difficult vascular access for trauma patients.
Duration: 30 minutes
Target Audience: Emergency department medical and nursing clinicians
Case discussion
This resource kit provides clinical staff the opportunity to practise the application and interpretation of a Viscoelastic haemostatic assay (VHA) trace (ROTEM) for the management of the bleeding trauma patient.
Duration: 30 minutes
Target Audience: Medical, nursing, and pharmacy clinicians
This resource kit provides the learner with the knowledge in the management of a patient who requires haemostatic resuscitation.
Duration: 30 minutes
Target Audience: Medical, nursing, and allied health clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of haemostatic resuscitation.
Courses
The approach to the patient with extremity trauma is the same as any other trauma presentation with attention to life threatening external hemorrhage before completing a structured ABCD assessment. In the patient with significant limb injury further attention to specific features to suggest compartment syndrome, presence of wounds that require antibiotic coverage and tetanus prophylaxis or metabolic management in crush injury should be considered in the initial assessment.
Major limb trauma may also require the use of tourniquets, splints and direct pressure for hemorrhage control and familiarity of available equipment and local processes for application and removal of these should be available for clinician use.
Training resource kits
Each kit is a collection of tools and resources to guide the effective delivery of a trauma education event. The kits are designed for use in any Queensland Health facility and can be modified by the facilitator to the needs of the learner, as well as the environment in which the education is being delivered.
Immersive scenario
This resource kit provides healthcare clinicians with the skills to assess and manage a patient with fat emboli following orthopaedic limb trauma.
Duration: 45-60 minutes
Target Audience: Emergency department medical and nursing clinicians
Case discussion
This resource kit provides healthcare workers with the knowledge and skills to effectively interpret ankle x-rays for correct alignment following injury.
Duration: 30 minutes
Target Audience: Emergency department medical and nursing clinicians, physiotherapists
This resource kit provides clinicians with the knowledge for use including indications and contraindications for traction splint application in femoral fractures following injury.
Duration: 30 minutes
Target Audience: Emergency department medical and nursing clinicians
Help us make these training resource kits better – complete our short survey or contact us with any feedback.
Other resources
Other resources and tools on the topic of extremity trauma.
Courses
Trauma – Acute Compartment Syndrome aims to provide healthcare workers with a basic knowledge of acute limb compartment syndrome epidemiology, pathophysiology and assessment. It also aims to improve their confidence and ability to recognise, escalate and refer patients for time-critical surgical management.
Target Audience: Clinicians involved in the management of acute trauma patients (eg: emergency, general practice, surgical and trauma ward), and others at risk of developing compartment syndromes.
In a collaborative effort to bolster disaster preparedness and response, Queensland Health, in association with the Jamieson Trauma Institute (JTI), has developed new Clinical Guidelines for Mass Casualty Incidents.
info
QHEPS Links
The latest guidelines can be accessed by clinicians across Queensland Health on QHEPS. (For staff only – this document is available on a QH computer only)
Find out more and access the guidelines via the JTI link below.
Clinical guidelines
Links to relevant clinical guidelines.
