Skip to Main Content

++

While on your night float rotation, you and other members of the surgical team are called to the emergency department (ED) in response to the activation of the trauma team. As the patient is being wheeled into the trauma bay, the paramedics inform you that the patient is a 56-year-old female who was a restrained driver in a motor vehicle crash (MVC). She rear-ended a stopped car going at a speed of approximately 45 mph. There was no loss of consciousness at the scene and the patient appears alert. The paramedics report that the patient has obvious deformities of her proximal upper right arm and distal left thigh. You hear your senior resident announce that she is going to begin the primary survey.

++
++
++

1. Why was it appropriate to initiate a trauma activation in this patient?

++
++

2. What is your role during this trauma? Where should you stand?

++
++

3. What is the goal of the trauma primary survey?

++

Trauma Primary Survey

++
Answers
++

  1. Per CDC guidelines, the trauma team should be activated if 1 or more specific anatomic, physiologic, and mechanistic criteria are met as illustrated by Table 2-1. The patient in this scenario meets criteria for trauma team activation given her involvement in a high-speed MVC and likelihood of her having at least 2 proximal long bone fractures.

  2. Although minor variations may exist from institution to institution, the trauma team at most academic medical centers consists of a team leader, an airway specialist, primary and secondary surveyors, and ED nurses. Note that depending on the nature of the injury, other specialized staff (ie, orthopedic surgery or neurosurgery) may also be present. It is imperative that members of the trauma team are aware of their roles to ensure that the best care possible is given to the traumatically injured patient. Trauma team members and their respective job descriptions are listed below and a diagram of their position with respect to the patient is illustrated in Figure 2-1:

    • Team leader (trauma surgery attending or the senior surgical resident until the attending arrives):
      • Obtains history from Emergency Medical System (EMS) staff
      • Directs team members on how and when to perform their respective tasks
      • Orders the administration of drugs, fluids, or blood products
      • Performs or assists with any lifesaving procedures
      • Determines the patient's disposition (ie, additional imaging, OR, ICU)
      • Discusses the patient's status with the family members
    • Airway specialist (2 people—anesthesiologist, ED attending, or senior residents of either specialty with 1 person serving as an assistant):
      • Controls the airway, ensuring patency
      • Performs any airway interventions, excluding the performance of a surgical airway
      • Maintains cervical spine stabilization
    • Primary surveyor (surgical resident):
      • Performs the primary survey, relaying all pertinent findings to the team
      • May perform the secondary survey, relaying all pertinent findings to the team
      • Performs or assists in ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.