Anaesthetists who manage patients with major trauma should consider undertaking advanced trauma life support (ATLS), European Trauma Course (ETC) or equivalent training, and should update their training at regular intervals.
Anaesthetists providing anaesthesia for trauma and orthopaedic surgery should learn and maintain expertise in a wide range of regional anaesthetic techniques, including central and peripheral neural blockade.57
All anaesthetists involved in the management of major trauma should understand the principles and techniques of damage control resuscitation to prevent lethal triad of hypothermia, acidosis and coagulopathy using low volume fluid resuscitation, blood products and damage control surgery.7
Anaesthetic trauma theatre teams should be trained in the correct use of all essential anaesthetic theatre equipment used for trauma surgery.
Staff in the recovery area and in the wards who receive patients after surgery with epidural infusions, nerve blocks or intravenous opioid infusions (including patient controlled analgesia) should have received up to date formal training in caring for these forms of analgesia.
Anaesthetic staff expected to care for patients with epidurals and continuous nerve blockade in situ should be trained to local guidelines before they top up medication or care for such patients.
Anaesthetic practitioners involved in the administration of anticoagulant therapies should have current and up to date knowledge in their use.
Services should be available for:
There should be regular multidisciplinary in situ simulation training for the initial management of major trauma care and resuscitation to standardise clinical practice. Simulation can improve technical and non-technical skills including communication and teamwork. 58
Awareness of regional analgesia benefits in chest trauma and early referral to acute pain services should be emphasised within the multidisciplinary trauma team.59
