EMCrit 278 – Labors of Trauma – Blunt Edition (Part 1) - a podcast by Scott D. Weingart, MD FCCM

After reviewing many recordings of major trauma resuscitations, I have come to the conclusion that we are not training our learners on how to perform as a Trauma Team Leader (TTL). They are forced to extrapolate from ATLS, a course never designed for a team at a Level I trauma center. Trauma resuscitations as opposed to medical are a bounded reality. Both the time in the bay and the menu of options are limited--the complete list could be delineated and therefore available for novice TTLs. For a few weeks, I set out to do exactly that. I then sent it out to Chris Hicks (@humanfact0rz) for peer review. His feedback was so good, that I asked him to co-author this project with me. If the response to this project is positive, we will work on the penetrating edition as well.







Blue=cognitive tasks for the TTL



Red=TTL must assign to a subteam (operational)



Solid=always happens in every trauma



Dotted=May happen based on patient injuries or severity



 







* Zero Point Survey

* Team Leadership with Cliff Reid

* EMCrit #230 - Resuscitation Communication

* COMM CHECK: More On Resuscitation Communication



 







 







 







 







* Rapid Infusion Catheter



 





Revised Assessment of Bleeding and Transfusion (RABT)



* Penetrating Trauma

* Shock Index > 1.0

* Pelvic Fracture

* Positive Abdominal FAST



>=2 had sensitivity of 84% and a specificity of 77%



World J Surg 2018;42:3560



5 Sites of Bleeding



* Chest

* Intra-Peritoneal

* Retro-Peritoneal/Pelvis

* Thigh

* Street



 







* Hemostatic Resuscitation by Richard Dutton, MD

* EMCrit Podcast 30 Hemorrhagic Shock Resuscitation



 







 







 



EMCrit Podcast

Further podcasts by Scott D. Weingart, MD FCCM

Website of Scott D. Weingart, MD FCCM