Search

The majority of patients presenting to TUs with major trauma should be transferred to an MTC after immediate management by adopting a ‘Send and Call’ policy.⁶³

The trauma team should attend in cases of suspected major trauma according to predefined local criteria. The trauma team should also be called out if there are unexpected findings after arrival in triage-negative patients, and to receive patients following interhospital transfer.

There should be a local protocol for immediate or emergency access to an operating theatre or intervention suite, with appropriately trained and experienced staff to provide rapid intervention in life threatening or limb threatening conditions.³⁵

All patients requiring acute intervention for haemorrhage control should be rapidly transferred to a definitive management area, e.g. operating room or intervention suite, without delay.⁶⁴

Dedicated trauma operating lists, staffed by trauma teams should be scheduled daily, enabling maximal efficient use of theatres. This includes the provision of extra trauma lists in the evenings and at weekends. These measures aim to limit overnight operating, with less experienced staff and limited postoperative care facilities.

There should be a flexible approach to trauma list planning and management to allow for interruption from emergency cases including the provision of daily trauma lists that prioritise hip fractures and identification of a ‘Golden Patient’ to maximise efficiency wherever possible.^{65, 66} Theatre teams should be informed whenever an unstable patient with major trauma is expected, has arrived...

All acute hospitals should have a defined major incident plan. The plan should be built around the network of MTCs, TUs and LEHs. A prehospital triage tool should be used to determine where patients should be taken.⁶⁷

Trauma checklists should be used for the rapid transfer of patients from one clinical area to the next to ensure consistent patient care and documentation of treatment.^68,69

Rapid and effective communication between healthcare professional and the individual are key to good patient care, not only for initial management but for the whole of the recovery trajectory. Communication strategies should consider the use of new technologies, e.g. smart phones, and standardised methodology.^70,71

Facilities for monitoring, ventilation of patients’ lungs and resuscitation, including defibrillation, should be available at all sites where patients are anaesthetised.^4,22