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Trauma Guideline Manual - SUNY Upstate Medical University

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26____________ <strong>Trauma</strong> <strong>Guideline</strong> <strong>Manual</strong><strong>Upstate</strong> Medial <strong>University</strong> <strong>Trauma</strong> CenterTo define the procedure for treatment of multiple trauma patients simultaneously admitted to theEmergency Department.DEFINITION:Multiple trauma patients: More than one patient arriving in the trauma resuscitation areasimultaneously or sequentially over a short time span.GUIDELINES:1. In general, patients are admitted to the trauma room one at a time and the usualassignment of responsibilities is followed (see <strong>Guideline</strong>: Role Assignment). The traumaand EM attendings will provide supervision for all patients.2. Assume the following responders: <strong>Trauma</strong> attending, EM attending, ED senior resident,ED junior resident, trauma junior resident, trauma intern, ED intern (intern = PG1). If notspecifically assigned, the responders will help where needed.3. When multiple patients are admitted simultaneously, the following assignments are made(acuity: Patient A > Patient B > Patient C > Patient D):a. Two patients:i. Patient A –Chief <strong>Trauma</strong> resident, junior EM residentii. Patient B –<strong>Trauma</strong> or EM attending, EM senior resident.b. Three patients:i. Patient A – Chief trauma resident.ii. Patient B – Senior EM residentiii. Patient C – EM attendingc. Four patients:i. Patient A – Chief trauma residentii. Patient B – <strong>Trauma</strong> attendingiii. Patient C – Senior EM residentiv. Patient D – EM attending4. The <strong>Trauma</strong> and EM attendings will provide general supervision for all patients.5. Make sure that all teams are communicating with each other to continually assess changingacuity and priorities for diagnostic studies. All important information should be relayed tothe most senior physician.6. Consider the activation of the back-up <strong>Trauma</strong> team (see Practice <strong>Guideline</strong>: Activation ofthe Back-Up <strong>Trauma</strong> Team)If additional trauma patients are anticipated, the EM attendingshould consider activation of the disaster plan according to established procedures.OPERATIONAL GUIDELINES: ACTIVATION OF THE BACK-UP TRAUMA TEAMOBJECTIVES:1. To define the situation in which the back-up team should be notified.2. To define the mechanism by which the back-up team should be activated.

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