Published: 05/09/2019

Trauma and stabilisation

Learning outcome:

  • Build on the knowledge, understanding and skills obtained in Basic Level training, so developing greater confidence and ability to provide clinical care to patients with multiple injuries
  • To gain an in-depth understanding of how to manage massive blood loss in the multiply injured patient with an associated head injury  
  • To gain in-depth understanding of the problems associated with trauma and: severe burns; electrical injuries; drowning/near drowning; hypothermia

Core clinical learning outcomes:

  • Be an effective member of the multi-disciplinary trauma team and takes responsibility for the initial airway management of the multiply injured patient with distant supervision
  • Be able to manage acute life-threatening airway problems safely and effectively with distant supervision
  • Provide safe perioperative anaesthetic care [from arrival in the Emergency Department through to post-operative discharge to the ward from recovery or intensive care] for ASA 1-3 patients with multiple injuries with distant supervision, whilst demonstrating understanding of knowing when to seek senior help

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Final examination identified in the FRCA examination blueprint section.

Knowledge

Competence

Description

Assessment

Methods

GMP

MT_IK_01

Recalls/describes the complex pathophysiological changes that occur in all patients [including children] with multiple injuries

A,C,E

1

MT_IK_02

Describes the perioperative anaesthetic management of patients with multiple injuries including head, facial, neck/spinal, thoracic, abdominal, pelvic and peripheral trauma

A,C,E

1,2,3

MT_IK_03

Explains the reasons for, and benefits of, the hospital triage of trauma patients and the scoring systems used

C,E

1,2

MT_IK_04

Describes strategies for minimising secondary brain injury in patients with multiple injures

C,E

1

MT_IK_05

Describes the initial assessment, management and resuscitation of patients with:

  • Severe burns
  • Electrical injuries
  • Drowning and near drowning
  • Hypothermia

C,E

1,2,3

MT_IK_06

Recalls/explains the management of massive blood loss including the use of rapid infusion devices

A,C,E

1

MT_IK_07

Explains the implications, prevention and management of coagulopathy, hypothermia and acidosis in multiply injured patients

A,C,E

1,2

MT_IK_08

Describes the management of children with multiple injuries, comparing and contrasting with that of adults [cross reference paediatric anaesthesia]

C,E

1,2,3,4

MT_IK_09

Describes the specific ethical and ethnic issues associated with managing the multiply injured patient, including issues that relate to brain stem death and organ donation

C,E

1,2,3,4

MT_IK_10

Discusses the indications and contraindications of regional anaesthesia and peripheral nerve blocks in multiply injured patients for the provision of analgesia, both initially and perioperatively

C,E

1,2

MT_IK_11

 Discusses the principles of clinical management for stabilisation of patients with multiple injuries requiring inter-hospital transfer strategies used, how safe transfer is undertaken, monitoring requirements and the options for modes of transfer [cross ref Transfer]

C,E

1,2,3,4
Skills

Competence

Description

Assessment

Methods

GMP

MT_IS_01

Demonstrates the ability to lead the multi-disciplinary trauma team to ensure that the primary survey, resuscitation and secondary surveys are conducted appropriately in non-complex trauma patients.  

A,S

1,2,3,4

MT_IS_02

Demonstrates advanced airway management skills in trauma patient [including those with suspected unstable cervical spine] including surgical airway techniques 

A,S

1,2

MT_IS_03

Demonstrates ability to communicate effectively with:

  • Senior colleagues when planning/organising definitive care
  • Colleagues in the referral centre when organising the transfer of a patient
  • Relatives, showing due compassion and understanding 

A,M

1,2,3,4

MT_IS_04

Demonstrates safe perioperative anaesthetic management of patients with multiple injuries requiring early surgery, including the management of major blood loss and associated coagulopathy, hypothermia and acidosis

A,C,E

1,2,3,4

MT_IS_05

Demonstrates correct preparation of patients for safe transfer including ensuring adequate resuscitation, appropriate accompanying personnel and the use of checklists

A,C,E,M

1,2,3,4

MT_IS_06

Demonstrates safe inter-hospital transfer of stable trauma patient[s], including those with brain injury, whilst also ensuring the safety of accompanying personnel 

A,C,E,M

1,2,3,4

MT_IS_07

Demonstrates the ability to interpret imaging relevant to the primary survey

A,C,E

1,2