Limbs can often be involved in traumatic injuries from accidents in the workplace or farming for example. They can have a devastating impact on not only the patient but on bystanders. Today Danielle speaks to Mr Andrew Oppy, lead orthopaedic trauma surgeon at the Royal Melbourne Hospital to discuss how to approach the trauma patient with a significant extremity injury and provides some great insight into management of the affected limb. Current at date of publication 26/10/2020.

Talking Trauma

Traumatic Limb Injuries

As with all trauma care, an organised approach to patient assessment is essential: ensuring life threatening injuries are identified and the patient is stabilised is the priority. Facial injuries that are not affecting the airway or causing life threatening haemorrhage can be assessed as part of the secondary survey, no matter how disfiguring the injuries may appear. Today we are joined by Alf Nastri, Head of the Maxillofacial department at Royal Melbourne Hospital.

Maxillofacial Trauma

 Haemorrhage is a major contributor to mortality in the pelvic trauma patient, and a large number of these patients go on to have other associated injuries. Today we are joined by Dr George Plunkett, Emergency Physician at the Royal Melbourne Hospital to discuss the assessment, identification of injuries and management of pelvic trauma patients including George's tips for ensuring good pelvic binder control. Current at date of publication 28/09/2020. 

Pelvic Trauma

Thoracic trauma is a common injury in the multi-trauma patient and a significant cause of mortality. Life threatening injuries identified in the primary survey need to be addressed at the time before moving on to the secondary survey. In this episode Danielle is joined by Mr Phillip Antippa, Cardiothoracic surgeon and Head of Cardiothoracic surgery service at Royal Melbourne Hospital to discuss early identification & management of traumatic chest injuries

Thoracic Trauma management

Early management of head injury is directed at minimising secondary brain injury by avoiding periods of hypoxia and hypotension and applying basic management principles in support of the injured brain. In this podcast we are joined by Prof Kate Drummond, director of Neurosurgery at the Royal Melbourne Hospital to discuss one of the most common and significant causes of mortality in Australia. Current at date of publication 08/08/2020.

Traumatic Brain Injury

Trauma patients are predisposed to hypothermia for a variety of reasons including exposure to the environment and disordered homeostasis. Serious sequelae for major trauma patients that remain hypothermic include coagulopathy and acidosis and an associated increased risk of mortality. Today we are chatting with Dr Sharyn Ireland, a clinical nurse educator at The Alfred Emergency and Trauma Centre about early identification of the hypothermic patient, physiological effects of hypothermia and strategies to manage it in the major trauma patient. Current at date of publication 13/07/2020.

Hypothermia in trauma

 The critical trauma patient undergoes a number of moves throughout their care journey and can be a challenging group to safely manage. Today Danielle is chatting with Dr Shaun Baxter, an Emergency Consultant at The Alfred Hospital as well as Consultant Retrievalist and Clinical Coordinator at Adult Retrieval Victoria to discuss his process for safely moving the unwell trauma patient, including how best to prepare and the importance of clear communication. Current at date of publication 20.06.2020. 

Moving the critical trauma patient

 Stopping the bleeding following trauma is of paramount importance in the critical first moments post injury for trauma care providers of both Paediatrics and Adults. Dr Peter Archer, Emergency Medicine consultant at the Royal Children’s Hospital and consultant retrievalist for Adult Retrieval Victoria joins us to discuss principles related to haemorrhage control in trauma resuscitation, as well as addressing the topic of compressive devices to control extremity haemorrhage. Current at date of publication 10/06/2020. 

Stop the bleeding

The time immediately after injury is crucial in the management of the trauma patient. The primary survey is designed to identify and treat life-threatening injuries quickly and is indicated for the evaluation of all trauma patients. In this podcast, Dr Jenny Jamieson, Emergency Medicine Consultant at The Alfred Hospital and Monash Medical Centre talks to us about the principles behind the Trauma Survey, including the Primary, Secondary & Tertiary evaluation with a focus on the initial identification and management of injuries. Current at date of publication 29/05/2020.

Trauma Survey

 Physical trauma starts with the transfer of energy to the body from an outside source. Dr Joseph Mathew, an Emergency Physician & Deputy Director of the Trauma Service at the Alfred discusses how knowledge of patterns of injury and common mechanisms together with patient presentation can help us to have a healthy clinical suspicion of potential injuries related to that trauma. Joseph shares his knowledge and experience on known injury relationships to strengthen your assessment of a major trauma patient. Current at date of publication 21/05/2020. 

Patterns of Injury

Identifying potential injuries of the spine of a trauma patient and choosing the best imaging modality to investigate these may be challenging to navigate, particularly where radiology services have limited availability and/or accessibility. Associate Professor Dinesh Varma, Director of Trauma and Emergency Radiology at The Alfred Hospital, talks us through how factors such as clinical assessment, and mechanism of injury can play a vital role in decision making for imaging, and tips on clearing the spine. Current at date of publication 14/05/2020.

Spinal Imaging in Trauma

Trauma patients are at high risk of developing Trauma Induced Coagulopathies; the patient sub-group already using prescribed oral anticoagulants for pre-existing illness are at an even greater risk of developing complications related to this. Dr Giles Kelsey, Consultant Haematologist at The Royal Melbourne Hospital and The Alfred Hospital talks to us about assessment, identification and management of bleeding patients from trauma with a particular focus on those on Oral Anticoagulant Medication. Current at date of publication 01/05/2020.

Oral Anticoagulants and Major Trauma

Debriefing after trauma is an important quality improvement process that allows the team as a whole to reflect on their performance after a high stakes clinical scenario. Dr Luke Phillips, an Emergency Physician at The Alfred Hospital talks to us about the principles of debriefing after a major trauma with a focus on “Hot Debriefing”. Current at time of publication 05/03/2020.

Hot Debriefing after Major Trauma

The obstetric trauma patient presents as a complex scenario for all clinicians. We often get distracted by the unborn child, but foetal survival depends on effective maternal resuscitation. With the use of case studies, Dr Emma West – Consultant Emergency Physician at the Royal Melbourne Hospital, talks us through the initial assessment and management priorities of the pregnant major trauma patient. Current at date of publication 5/03/2020.

Obstetric Major Trauma

Blunt abdominal trauma makes up a significant proportion of traumatic injuries in Australia. Dr Joseph Matthew, from Alfred Hospital helps us to gain a better understanding of blunt force mechanisms & the impact of a shift to more conservative management approaches has seen on trauma outcomes. Current at date of publication, 29/1/2020

Blunt Abdominal Trauma

Trauma focused educational miniseries produced for health care clinicians involved in the care of major trauma patients in Victoria. Each episode brings evidence based information through discussions with trauma experts on pertinent topics for trauma care. The series is produced on behalf of Victoria’s Department of Health and Human Services, in collaboration with State Trauma Committee.

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Talking Trauma

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