Trauma Nursing Interventions

Guidelines:

• Know expectations and population
  • Trauma center
  • Heart center
• Facility policy and training
  • Carts
  • Standby OR/staff
  • Call-lists for providers
• Life, limb, function
• Triad of death
  • Coagulopathy
  • Metabolic acidosis
  • Hypothermia
    • Warm OR!

Considerations:

• HOT, lead, warm room, gowns
  • ice vests, sweatbands under cap, etc
  • PPE is a must
• Find help, don’t circulate alone
• Know mechanism of injury
  • Ortho? Organ lac?

Nurse’s role:

• Facilitate transfer
  • Challenging. gear/anes/vent/foley
  • Clear path for much traffic
• Prepare OR
  • Space
  • Gear – C arm?
  • Personnel
  • Cellsaver?
    • Contract?
• Family

Pitfalls:

• Gear no ready
  • Sets
• “On call” not ready
  • Report times
• Chaotic transfer, no report
• No leader
• No runners
  • Labs left on cart etc

Examples:

• MVA in ER, 3 patients during normal operative day. (clear 3 OR’s, cancel routine cases as needed, gain a clear timeline of expected availability of rooms, equipment. Maintain communication regarding status and plan)

Linchpins (Key Points):

• Trauma in the OR is unpredictable and utilizes many resources. Balancing availability with fiscal responsibility is challenging