Introduction

These guidelines have been developed following extensive consultation and review. They are endorsed by the Auckland City Hospital Trauma Service in collaboration with other services.

The treatment of severe trauma is ‘time critical’. Timely and appropriate intervention reduces preventable levels of mortality, complications and lifelong disability amongst people who sustain a major trauma.

The initial assessment of a trauma patient is a team process. Most patients with major trauma require the input of a number of different specialty groups. Often this does not extend outside the trauma team however the input of orthopaedic, neurosurgical, maxillofacial or plastic surgical teams may be required. Notify specialists early about severely injured patients

Multiple major trauma patients at the same time are common and can place considerable stress on the system. This can lead to situations where patients who have severe but not immediately obvious injures are overlooked. When this situation arises assistance should be summoned early.

The intent of these guidelines is to provide clear consistent guidelines around the process of care and treatment for trauma patients. It is expected these guidelines will be followed by all staff. Variation from these guidelines are made only after careful consideration.

These guidelines are in four parts.

  • Part one explains the trauma call process.
  • Part two outlines they standard approach for treatment of injuries
  • Part three has the algorithms for treatment of common injuries
  • Part four has the northern region inter-hospital transfer guideline that indicate which patients should stay at Auckland City Hospital, and which should be transferred to Middlemore. They also identify specific conditions which indicate transfer into Auckland from regional referral centres.

Auckland City Hospital (ACH) is the regional tertiary referral hospital for the care of the severely injured adults.

ACH receives patients with a wide range of injuries, both directly from the scene and following transfer from other hospitals. ACH provides de nitive care for these injuries.

Delays to definitive care increase morbidity and mortality.

ACH has a Trauma Team system which provides immediate skilled emergency care for trauma patients in the Department of Emergency Medicine and facilitates early progress to de nitive care. These guidelines describe the approach to major trauma patients.

Read and know them before you take on a role within the trauma team.