Preparing the Trauma Patient for Surgery
Apr 14, 2025
๐ฅ Preparing the Trauma Patient for Surgery
Trauma patients are perhaps the most demanding patients of all, with several competing factors and an ever-changing, dynamic clinical picture that is time critical. โฑ๏ธ Most networks will have some form of trauma response call ๐จ prior to the patient arriving in theatre, allowing some time for staff to prepare! ๐งโ๏ธ๐ฉโ๏ธ
When preparing for a trauma patient, here are your top 5 considerations! โ
๐ฉบ Primary Survey and Resuscitation
๐ This follows the Advanced Trauma Life Support (ATLS) principles:
Airway
โค๏ธ Breathing
๐ฉธ Circulation
๐ง Disability
๐งโ๏ธ Exposure (ABCDE)
โ ๏ธ Immediate life-threatening issues must be addressed prior to transfer to the operating suite, with haemodynamic stability a priority, often requiring ๐ fluid resuscitation and ๐ฉธ transfusion.
๐ผ๏ธ Imaging and Diagnostics
๐งพ Targeted imaging helps identify injuries needing surgical intervention. Standard trauma imaging includes:
๐ธ Chest and pelvic X-rays
๐ฒ๏ธ FAST (Focused Assessment with Sonography for Trauma)
๐ง CT scans
โณ Timely and accurate imaging guides surgical planning and prevents missed injuries, however unless it pertains to surgery, it should not delay transfer to the operating suite.
๐ง Airway Protection and Cervical Spine Clearance
๐ฃ๏ธ Airway management is essential, particularly in patients with ๐ค altered consciousness or facial trauma.
๐ฆด Cervical spine injuries must be assumed in all trauma patients until proven otherwise.
๐ Clearance involves clinical assessment in alert patients without neck pain or neurological symptoms and sometimes imaging like a CT scan ๐ง .
๐๏ธ The C-spine must remain immobilised until confirmed clear to prevent spinal cord injury ๐งฌ.
๐ Definitive Diagnosis and Surgical Planning
๐ Once life-threatening conditions are addressed and imaging is complete, the surgical team can determine the need for and timing of surgery โฐ.
๐งช This includes evaluating coagulopathy ๐งฌ, organ dysfunction ๐ซ๐ซ, and the patient’s physiological status ๐ฉบ.
๐ฃ๏ธ Communication and Consent
๐งโ๏ธ Effective communication with the surgical, anaesthetic ๐, and nursing teams is vital.
๐งพ Where possible, informed consent should be obtained either from the patient or from the next of kin ๐ช.
๐ท If the patient is unconscious or unstable, surgery proceeds under implied consent, with thorough documentation ๐.
These steps ensure that the patient is stabilised ๐ก๏ธ as best as possible, risks have been considered and minimised โ ๏ธโก๏ธโ , creating a safe and timely pathway for surgery ๐ฅ with a team that is well informed and working cohesively ๐ค.
Build Knowledgeโ
Improve Safety โ
References:
ATLS Subcommittee, American College of Surgeons’ Committee on Trauma, and the International ATLS working group. Advanced trauma life support (ATLS®): The ninth edition. Journal of Trauma and Acute Care Surgery 74(5):p 1363-1366, May 2013.
Freedman, R., O’Donnell, A., Ross, N., & Herbert, L. (2022). The major trauma patient. In Oxford Handbook of Anaesthesia. Oxford University Press, Incorporated. https://doi.org/10.1093/med/9780198853053.003.0037
Stay connected with news and updates!
Join our mailing list to receive the latest news and updates from our team.
Don't worry, your information will not be shared.
We hate SPAM. We will never sell your information, for any reason.