Project Heal  Trauma Checklist
  • TRAUMA/SURGICAL/EMERGENCY MEDICINE CHECKLIST

     

    Welcome to the TRAUMA/SURGICAL/EMERGENCY MEDICINE Checklist for PROJECT HEAL. Thank you for accepting to be part of our group of experts. This checklist consists of resources i.e. manpower, skills, consumables, equipment that are deemed relevant for a health facility to be deemed TRAUMA/SURGICAL/EMERGENCY MEDICINE competent or biased. Please read and select the relevance level of the underlisted.


    The relevant resources would be scored and used in developing a system of ranking. The total scores will be used to develop a checklist for which hospitals can independently administer to determine their level of health care provision based on specific specialization and over score. These can then inform the emergency care services, referral facilities, health workers, and the general public on which facility provides which level of care.


    Be assured your response is confidential. Only aggregated results would be seen by the Delphi group.


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  • HOSPITAL ORGANIZATION
  • Presence of Trauma/Emergency/Casualty Service in the Hospital.
  • Designated Head of trauma (registered trauma surgeon)
  • Designated Head of EM (registered Emergency medicine Specialist)
  • Designated medical officers in emergency medicine/Casualty
  • Designated Emergency medicine specialist on 24hr call
  • Designated trauma surgeon on 24hr call
  • Designated neurosurgeon on 24hr call
  • RELEVANT DEPARTMENTS

  • EM
  • ANAESTHESIA
  • ORTHOPAEDIC SURGERY
  • NEUROSURGERY
  • CLINICAL DISCIPLINE AVAILABILITY
  • 1. In-house 24 hours a day (available within 10 minutes)

  • a. EM
  • b. Trauma surgery/trauma critical care
  • 2. On call available within 20 minutes

  • a. General surgery
  • b.     Anaesthesiology
  • c. Cardiac surgery
  • d. Cardiology
  • e. General surgery
  • f. Emergency Medicine
  • g. Family medicine
  • h. Hand Surgery
  • i. Infectious disease
  • j. Intensive care
  • k. Internal medicine
  • l. Microvascular Surgery
  • m. Neurosurgery
  • n. Nuclear medicine
  • o. Obstetrics/gynaecology
  • p. Ophthalmic surgery
  • q. Oral/maxillofacial surgery
  • r. Orthopaedic surgery
  • s. Paediatric surgery
  • t. Paediatrics
  • u. Plastic surgery
  • v. Pulmonary medicine
  • w. Radiology
  • x. Thoracic surgery
  • y. Urology
  • z. Vascular surgery
  • PERSONNEL

  • 1. Designated doctor in charge of the shift
  • 2.  Doctor with special competence in care of critically injured is a designated member of the trauma team and is physically present in the emergency department 24 hours a day
  • 3. ATLS(R)-trained personnel 24 hour a day
  • 4. ACLS(TM)-trained personnel 24 hours a day
  • 5  A Nursing personnel with specific training in trauma care who provides continual monitoring of the trauma patient from hospital arrival to disposition in ICU, or Patient care unit
  • The following are a list of Medical resuscitative equipment. Please list the relevance of each item in the emergency/casualty room

  • Oral or nasal airways
  • Suction device: at least manual (bulb) or foot pump
  • Suction device: powered: electrical/pneumatic
  • Suction tubing
  • Yankauer or other stiff suction tips
  • Laryngoscope
  • Endotracheal tube
  • Oesophageal detector device
  • Bag-valve-mask
  • Basic trauma pack
  • Magill forceps
  • Oxygen supply (cylinder, concentrator or other sources)
  • Mechanical ventilator
  • Nasal prongs, face mask, associated tubing
  • Needles & syringes
  • Bag–valve–mask
  • Chest tubes
  • Underwater seal bottle (or equivalent)
  • Arterial blood gas measurements
  • Pulse oximetry
  • Capnography
  • ASSESSMENT AND EXTERNAL CONTROL OF HAEMORRHAGE

  • Clock or watch with second hand
  • Stethoscope
  • Blood pressure (BP) cuff
  • Gauze and bandage
  • Arterial tourniquet in extreme situations
  • Fluid resuscitation
  • Crystalloid
  • Colloids
  • Blood transfusion capabilities
  • Intravenous infusion set (lines and cannulas)
  • Intravenous needle or equivalent
  • Central venous lines
  • Monitoring
  • Blood pressure (BP) cuff
  • Urinary catheter
  • Electronic cardiac monitor
  • Monitoring of central venous pressure
  • Right-heart catheterization
  • Laboratory facilities for haemoglobin or haematocrit
  • RESOURCE FOR HEAD INJURY

  • Recognize altered consciousness; internalizing signs, pupils
  • Maintain normotension and oxygenation to prevent secondary brain injury
  • Avoid overhydration in the presence of raised ICP (with normal BP)
  • Monitoring and treatment of raised ICP
  • CT scans
  • Burr holes (skill plus drill or other suitable equipment)
  • More advanced neurosurgical procedures
  • Surgical treatment of open depressed skulls fracture
  • Surgical treatment of closed depressed skull fracture
  • Maintenance of the requirement for protein and calories
  • Resources for neck injuries

  • Recognize platysmal penetration
  • External pressure for bleeding
  • Packing, balloon tamponade for bleeding
  • Contrast radiography, endoscopy
  • Angiography
  • Surgical skills to explore nock
  • Rescources for Chest Injuries

  • Autotransfusion from chest tube
  • Adequate pain control for chest injuries /rib fractures
  • Respiratory therapy for chest injuries/rib fractures
  • Rib block or intrapleural block
  • Epidural analgesia
  • Skills and equipment for intermediate thoracotomy
  • Skills and equipment for advance thoracotomy
  • Resources Basic GP Specialist Tertiary
  • Recognition of neurovascular compromise; disability prone injuries
  • Basic immobilization (sling, splint)
  • Spine board
  • Wrapping of pelvic fractures for haemrrhage control
  • Skin traction
  • Closed reduction
  • Skeletal traction
  • Operative wound management
  • External fixation (or its functional equivalent: pins & plaster)
  • Internal fixation
  • Tendon repair
  • Hand injury: assessment and basic splinting
  • Hands: debride, fix
  • Fasciotomy for compartment syndrome
  • Amputation
  • X-ray
  • Portable X-ray
  • Image intensification
  • Proper management of immobilized patient to prevent complications
  • Should be Empty: