Education Resources
Trauma Team Training
Updated 04/08/2024
Welcome to Bendigo ED’s Trauma Team Training course.
Over two consecutive Wednesdays we aim to give you a standardised approach to the management of critically injured trauma patients presenting to Bendigo Emergency Department.
We will cover the following areas using a combination of short talks and simulation:
- Trauma Reception
- Human Factors
- Shock Trauma
- Neuro Trauma
- Traumatic Cardiac Arrest
The course will culminate in the final afternoon of simulations covering everything taught on the course.
A particularly important part of this course is that you will work in multidisciplinary teams, recreating the team that will actually work together in resus for the reception of these critically ill trauma patients.
The topic of trauma is far too big to cover in just two days, we are therefore, focusing on these key areas, acknowledging that other important topics- for example, paediatric trauma, burns, spinal injuries, trauma in pregnancy etc. are not covered. Should you wish to explore these (and other trauma topics) further, a great place to start is the Trauma Victoria website. However, the principles taught on this course (the standardised approach to reception and assessment of trauma, human factors etc.) are applicable to any trauma scenario and while the course focusses specifically on trauma, many of the skills learned will be transferrable to any resuscitation scenario.
We are really excited to put on this course, we hope you find it useful, challenging and fun. As this is the first time the course has been run in this current format, we particularly welcome your feedback in order to fine tune the course for next time.
Any comments/questions, please contact Liam Hannon
Format
Pre-Reading
Some reading is listed below. Please do have a look at this in advance.
Lectures
We will introduce each topic with a brief lecture covering the key points and particularly anything specific to Bendigo.
Simulations
The bulk of the sessions will be spent running through scenarios in the Monash sim lab.
You will be split into two groups for the simulations, with one group observing while the other runs through the scenario.
The sims are designed to challenge you and will build in complexity over the two days. The final afternoon will cover anything from the entire course.
Just like in real life, patients in the simulations may die, regardless of what you do. Focus on the process rather than the outcome. Do be prepared for this.
To get the most out of the simulations, it is important to treat the scenario as you would if you were at work. With this in mind, please come wearing scrubs. There is always artifact created by the sim environment, a mannequin does not behave like a real person, there are procedures we cannot recreate in the sim lab. Imagine you were in resus with a real trauma patient in front of you. Talk to the patient, if you are doing a procedure, requesting blood, preparing drugs etc. imagine how long this would actually take, aim to recreate this. The more you buy into the scenario, the more you will get out of it.
Each simulation will be followed by a short, sharp debrief, initially led by the facilitators. Over the two days we aim to give you the skills to allow you to debrief the scenarios yourselves.
Confidentiality. What happens in the sim lab, stays in the sim lab. We want you to feel safe to have a go, try things, make mistakes in a safe environment. Please do not talk about what happened in the scenarios outside of this setting. You are however very welcome to talk about what you learned.
Logistics
The timetable for the course can be found here. The schedule is tight, please be on time.
On the 21st August, there are exams happening in the Monash building, please be quiet when entering and exiting.
Lunch will be provided on both days.
Reading
In preparation for the course please have a look over the following resources:
General Reading
Trauma Victoria have produced an extensive range of trauma resources
Some specific guidelines are highlighted in the relevant sections below
This is included as a reference only, you do not need to read the entire website before the course
Trauma Reception
Bendigo Trauma Call Activation Protocol
Can be accessed here.
Particularly focus on what triggers each trauma level and what response this gets
Trauma Victoria: Early Trauma Care
A one-page summary can be found here
Trauma Reception Video
You may notice some familiar faces in this video showing the Alfred’s approach to trauma reception
Useful Additional Resources
Bendigo Major Trauma Chart
American Spinal Injury Association- Spinal Cord Injury Worksheet
- Useful when completing a secondary survey if there is concern for spinal cord injury
Human Factors
Trauma Victoria: Teamwork and Communication
Zero Point Survey: a multidisciplinary idea to STEP UP resuscitation effectiveness
The Zero Point Survey is mentioned in the Trauma Victoria page above, here is the original article which explains the concept in more detail
Some strategies for decision making in resus
Making Things Happen
This excellent talk by Cliff Reid outlines his approach to resuscitation with a specific focus on human factors. Lots of really useful tips
Psychological Skills to Improve Emergency Care Providers’ Performance Under Stress
This article gives some useful strategies to for the individual to reduce individual stress levels during resuscitation
Shock trauma
Bendigo Health Massive Haemorrhage Protocol
Massive Haemorrhage Protocol Q&A
Several important concepts in shock trauma are explained in these series of articles from Life In The Fastlane
Major Haemorrhage in Trauma (Ignore the section on classification of haemorrhagic shock- this is of little/no clinical relevance in the real world)
Impact brain apnoea- a forgotten cause of cardiovascular collapse in trauma
This paper highlights the important effects of head injury on cardiorespiratory function and how isolated head injury can actually manifest as shock
A summary of this concept can be found on Life In The Fastlane
Some of the Evidence (interest only)
This is a landmark paper, the first RCT to show a mortality benefit with a restrictive fluid strategy reduced mortality
Summary of the landmark CRASH 2 trial, demonstrating a mortality benefit with TXA in bleeding trauma patients
Summary of the recently published PATCH trial, also looking at the use of TXA in trauma
Neurotrauma
Trauma Victoria- Traumatic Brain Injury
Overview of the management of a patient with a traumatic brain injury
Intubation of the Neurocritical Care Patient
This article covers the approach to intubation in a head injured patient
Traumatic Cardiac Arrest
Trauma Victoria- Traumatic Cardiac Arrest
Overview of the management of a patient with traumatic cardiac arrest
Australian Resuscitation Council: Management of Cardiac Arrest due to Trauma
Highlights the approach to traumatic arrest, specifically the differences from a standard cardiac arrest
European Resuscitation Council Guidelines 2021: Traumatic Cardiac Arrest/ Peri-arrest Algorithm
This is an excellent algorithm for the management of traumatic cardiac arrest
Royal Melbourne Hospital Traumatic Arrest and Thoracotomy Guidelines (for interest only)
Bendigo Health does not currently have a traumatic cardiac arrest or thoracotomy guideline.
Here you will find the Royal Melbourne Hospital guidelines covering these two topics
Traumatic Cardiac Arrest Guideline
Emergency Department Thoracotomy Guideline
Resuscitative Thoracotomy Lecture (for interest only)
This lecture is given by Dr Anne Weaver, emergency and prehospital consultant in London
It covers resuscitative thoracotomy in detail