EuAsia 2017 Day 3: Trauma

Initial trauma care (J Duranteau)

STOP THE BLEEDING – requires multidisciplinary task force

Communication vital

A major trauma centre is a specialty hospital not a hospital of specialties.

Damage control surgery and resuscitation should be emphasised by the team

Minimise time between arrival and operation

Aim for systolic BP 80-90mmHg (if TBI MAP 80mmHg)

  • Duranteau – if no response after 1l fluids, start vasopressors

Correct coagulopathy

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References

A major trauma centre is a specialty hospital not a hospital of specialties.

The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition

 

Ultrasound in trauma: what you need to know (A Wong)

 

Can trauma care be improved with simulation (HY So)

Simulation – strategy to mirror, anticipate or amplify the real situation

Learning process amongst professional is complicated

Debrief structure phase

  • Introduction
  • Reaction – emotion before cognition, go where the heat is
  • Debrief with good judgement

Simulation advantages

  • deliberate practice with feedback
  • uncommon events
  • reproducibility
  • ability to range the difficulty levels
  • absence of risk to patients

Hurdles

  • learners do not ‘buy in’
  • fidelity problematic
  • threatened – psychological safety crucial
  • confidentiality

Training the trainer is important

I hear and I forget. I see and I remember. I do and I understand. Confucius

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