A standardised approach should be taken when completing a trauma survey in pregnancy and a maternal-foetal trauma checklist should be considered as this lays the foundation for interdisciplinary collaboration in a stressful environment.87
In pregnant orthopaedic trauma patients, diversion to a centre with obstetric and trauma expertise directly from the scene of an injury should be considered, to avoid delay of appropriate specialist care.91
Staff should be vigilant for non-accidental injury in children with trauma injuries and should make enquiries of the circumstances around major trauma and ask if there are safeguarding concerns.
Healthcare workers, including the anaesthetist, must be aware of the local policy for child protection, and that they have an obligation to document and report any concerns to a responsible individual.85
Hospitals must have guidelines in place to ensure the safety of children admitted to hospital, to monitor injured children known to be at risk, and identify concerns arising from any injury or pattern of injuries.86 They must provide the appropriate training related to these guidelines.
All anaesthetists providing anaesthesia for trauma and orthopaedics should have appropriate knowledge, skills, attitudes and behaviour in accordance with the RCoA training standards.96
Anaesthetists with a specific interest in orthopaedics and trauma should deliver regular theatre sessions to ensure the maintenance of their skills and experience.
Anaesthetists with responsibility for the intraoperative care of trauma patients should ensure that their skills and knowledge of current recommendations are up to date, particularly in the management of major haemorrhage.
