Traumas in ER: Examination Process ?

[AnthonyM83]

So, whenever we get a major trauma and go to our level 1 trauma centers, we get surrounded by residents, attendings, nurses, techs, and registration, as they all rush to do their thing. I always find myself a corner and stay for as long as I can...almost had a doctor let me to up to the OR, but someone else told him it was against policy. Anyway, I love watching ::wink:: and seeing how they assess the patient. Their method usually reminds me of steps I could do to have a better assessment before ER arrival.

Does anyone have any good articles or explanations of the processes they do at the trauma centers? It'd be nice to have more to think about while I'm watching...maybe different protocols you do for different calltypes? Things your checking for with different tests and what they would tell you?

I'm trying to get more out of my ER visits in general for all patients. On a GSW, I was able to do cardiac massage along with the residents for training purposes and got a good anatomy lesson. The other day a peds doctor explained how to better assess lung sounds on children. This type of stuff isn't common in my area with the EMTs, so I really have to try get a conversation going with the docs. Any tips on this would be appreciated, too.

[JakeEMTP]

Have you ever noticed how patient assessment in the trauma bay mirrors a detailed assessment in the field? Albeit, there is more help and usually more lighting, but they do a thorough head to toe detailed assessment. When we ( EMS in general ) are doing it, it is usually performed in the back of a moving ambulance.

It is important to give the trauma staff a very good verbal report. There treatment is a continuation of ours. I have worked many a code along side the trauma team and like you, have learned a great deal. I actually did my first ( and only to this point ) surgical cric in the trauma bay, excellent skill check off :wink:.

I'm not sure if I know of any protocols which would be different from yours. We can do quite a bit without calling for approval from medical direction, but not knowing what your protocols look like, I can't honestly say.

I'll try and look for some articles. I'm tired and don't have the energy right now.

[Dustdevil]

Google ATLS (Adavanced Trauma Life Support) and you'll find the info you are looking for scattered about the net.

Back in 05, when I started refreshing and prepping for deployment, I found this site which is a helpful overview of ATLS principles in outline format:

http://www.jwolfe.clara.net/WebPages/Atls.htm

It will give you a good overview of the process. If you take that info and use it as an outline for self-guided research and study, you'll get pretty comfortable with what is going on in the ER. And you will very definitely understand and anticipate what is going on in the trauma bays.

[AZCEP]

The more resources you look at the better, but the key to assessment is having a pattern to follow. Most doctors, residents in particular, are willing to teach you something. Take the opportunity to ask questions you have, and don't get offended when they tell you something you don't like.

Doctors are no better, or different, from all people. Some are very good at what they do, and some not so much. They all have information that you can use, and some of it may well surprise you.