The trauma callBMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2272 (Published 14 June 2018) Cite this as: BMJ 2018;361:k2272
- Simon J Mercer, consultant anaesthetist1,
- Elizabeth V Kingston, specialty trainee in anaesthesia2,
- Clinton P L Jones, consultant anaesthetist1
- 1Aintree University Hospital NHS Foundation Trust, Liverpool, UK
- 2Health Education England North West School of Anaesthesia, UK
- Correspondence to S Mercer
What you need to know
A trauma team assembles rapidly in response to a major trauma alert and has a dedicated leader, usually an emergency medicine consultant, supported by a multidisciplinary team.
Initial rapid assessment follows the mnemonic <C>ABCD with control of catastrophic bleeding, assessment of airway, breathing, circulation, and disability.
Initial investigations to guide early management include portable radiography for chest and pelvis, point of care testing for venous blood gas analysis, and assessment of coagulation status.
The team leader co-ordinates care, following the principles of damage control resuscitation to control bleeding and restore tissue perfusion.
Trauma is the leading cause of death for people under 40 in the UK, and a major cause of debilitating long-term injuries.1 Major trauma usually refers to a seriously injured patient or a patient with multiple injuries requiring a coordinated multidisciplinary approach to their care. Twenty percent of patients in the UK survive severe trauma. 2 An audit of the major trauma services in England identified deficiencies in care contributing to high in-hospital mortality in trauma patients.2 Typically, such patients are managed in the emergency department after a trauma call is put out to assemble a trauma team. The trauma team must rapidly assess seriously injured patients and start treatment in a timely manner.
Here we aim to help clinicians familiarise themselves with the essentials of managing patients with major trauma as part of a team in an emergency department, drawing from our experience, and from 2017 guidelines from the UK’s National Institute for Health and Care Excellence (NICE) for head injury and major trauma. The practice and team constitution may differ based on resources and organisation of health services in different countries, however we expect the basic principles of organising and responding as a trauma team will be relevant.
Who is involved in a trauma team?
Trauma teams are assembled rapidly by …