Trauma Reminders 2023
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Trauma Reminders 2023
Burns Resuscitation Worksheet!
The burns worksheet uses the Lund & Browder chart to calculate the TBSA burned as it is considered more precise. This Horizon and Vitalité approved burn worksheet forms part of the permanent record in the patient’s chart. For additional guidance on burn treatment, consult the Burns Consensus Statement.
Acute Spinal Cord Injury and Maintaining a Higher Mean Arterial Pressure (MAP)!
Studies have shown that maintaining a higher MAP can improve outcomes in patients with acute spinal cord injury. Higher MAP levels can improve spinal cord perfusion, reduce secondary injury, and potentially improve neurological outcomes. Targeting a MAP greater than 85-90 mmHg is recommended.
Cited articles:
- Najemedd A. Attabib, Dana El-Mughayyar, George Kolyvas, et al. “Saint John Regional Hospital Acute Spinal Cord Injury Management Protocol” Internal report, Horizon Health Network Department of Neurosurgery. Updated March 2023
Trauma Line!
The Trauma Line was created to provide real-time clinical support, equitable access to trauma care for the seriously injured child or adult using standardized, predictable process of care and managing transfer logistics. The Trauma Line is intended for use when patients’ injuries qualify under the Trauma Transfer Guidelines AND who present within 24 hours of injury. This line is staffed by Ambulance New Brunswick staff, which will connect you with a Trauma Control Physician (TCP) who can provide guidance and help to ensure the patient is transferred to a facility that is best equipped to manage their needs.
For later presentations, physicians are encouraged to consult appropriate specialists directly and arrange transfer as required.
Transfer Sedation
When transferring intubated patients, ensuring adequate sedation and analgesia is essential for their safety and comfort. The Richmond Agitation and Sedation Score (RASS) is commonly used to monitor sedation levels. A RASS target score of -4 is recommended for the transfer of our intubated patients. This level of sedation is characterized by no response to voice but movement or eye opening to physical stimulation.
Although bolus doses of both analgesia and sedation are great starting points for patients after intubation, setting them up on infusions for both medications is recommended, particularly for those hitting the road on transfer. For additional information, consult the Rapid Sequence Intubation (RSI) consensus statement.
Trauma Resource Nurses!!
Trauma NB’s Resource Nurses (TRNs) are available to help with questions regarding trauma cases and inquiries about trauma education. Reach out to us at TraumaNB@HorizonNB.ca to connect with your TRN.
August 22, 2023
