trauma

podcasts and other resources

“In blunt abdominal trauma, ultrasound-based algorithms are often assumed to have merits in shortening the primary trauma assessment, triaging patients more precisely, avoiding unnecessary interventional procedures, and reducing costs. These assumptions are NOT supported by the available scientific data. In the stable, adult, blunt abdominal trauma patient, ultrasound is NOT as sensitive as computed tomography in diagnosing intra-abdominal organ injury.”
- BestBets.org - US in blunt abdominal trauma
Video podcast - EM Chest Radiology by Stuart Swadron (36min)
Video podcast - Facial Trauma by Kevin Bush (21min)
Video podcast - Missed Traumatic Injuries by Shawn Janes (26min)
Video podcast - Upper Extremity Trauma by Joe Haegert (33min)
Video podcast - The Difficult Airway 2008 by Ron Walls (51min)
MJA 2009 - the rising incidence of assault in major trauma in Victoria
- mainly blunt trauma rather than penetrating trauma, and usually involving young men (~90%) on weekends between 2100hrs - 0400hrs.

major trauma services:
- Alfred, RMH, RCH
metropolitan trauma services:
- Austin, BHH, MMC, Dandenong, Frankston, Northern.
- Western, Maroondah and St Vincents’s for adults only.
metropolitan primary care services:
- Rosebud, Sandringham, Sunshine, Angliss, Mercy Werribee, Williamstown

As no international standard exists for the definition of major trauma, the VSTS has identified particular criteria as comprising major trauma.
The criteria were developed by the Victorian State Trauma Registry (VSTR) as broadbased inclusion criteria to ensure that data collection captures all major trauma patients in Victoria.
The VSTR records details of trauma patients whose principle diagnosis is injury, irrespective of age, and who meet any of the inclusion criteria.

Death after injury
Admission to an intensive care unit or high dependency area for more than 24 hours and mechanically ventilated after admission.
Significant injury to two or more Injury Severity Score (ISS) body regions or an ISS greater than 15.
Urgent surgery for intracranial, intrathoracic, or intra-abdominal injury, or for fixation of pelvic or spinal fractures.
Electrical injuries, drowning and asphyxia if admitted to an intensive care unit and receiving mechanical ventilation for longer than 24 hours.
All patients with injury as principal diagnosis whose length of stay is three days or more – unless they meet the exclusion criteria.
All patients with injury as principle diagnosis transferred or received from another hospital for further emergency care or admitted to a high dependency area - unless they meet the exclusion criteria.

Isolated fractured neck of femur.
Isolated upper limb joint dislocation, shoulder girdle dislocation (unless associated with vascular compromise) and toe/foot/knee joint dislocation – unless meets inclusion criteria 1, 2 or 4.
Isolated closed limb fractures only (for example, fractured femur or Colles fracture) - unless meets inclusion criteria 1, 2 or 4.
Isolated injuries distal to the wrist and ankle only (for example, finger amputations) - unless meets inclusion criteria 1, 2 or 4.
Soft tissue injuries only (for example, tendon and nerve injury and uncomplicated skin injuries) unless meets inclusion criteria 1, 2 or 4.
Burns to less than 10 per cent of the body - unless meets inclusion criteria 1, 2 or 4.
Isolated eyeball injury.