Trauma Guideline Manual - SUNY Upstate Medical University

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26____________ Trauma Guideline ManualUpstate Medial University Trauma 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 Guideline: Role Assignment). The traumaand EM attendings will provide supervision for all patients.2. Assume the following responders: Trauma 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 Trauma resident, junior EM residentii. Patient B –Trauma 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 – Trauma attendingiii. Patient C – Senior EM residentiv. Patient D – EM attending4. The Trauma 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 Trauma team (see Practice Guideline: Activation ofthe Back-Up Trauma 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.
Trauma Guideline Manual______________Upstate Medical University Trauma Center27GUIDELINES:1. At all times a trauma back-up team will be available. The back-up Trauma Attending can befound on the call schedule for Surgery.2. The back-up team should be notified under the following circumstances:a. The trauma team is in the OR trauma activation has occurred and no one can respond.b. The trauma team is occupied in multiple resuscitations.c. The trauma attending shall make the decision to activate the back-up team.3. When the trauma team is available again, the back-up trauma team should be notified thatthey are no longer needed.4. If patient demands exceed resources available, consider activation of the mass casualtyplan.
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Trauma Guideline Manual - SUNY Upstate Medical University

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