Transcription of Trauma Guidelines - Home | Stanford Medicine
1 Trauma GuidelinesJune 2016 Eye OpeningSpontaneous4To Voice3To Pain2 None1 Verbal ResponseOriented5 Confused4 Inappropriate words3 Incomprehensible words2 None1 Motor ResponseObeys commands6 Localizes to pain5 Withdraws to pain4 Abnormal flexion3 Abnormal extension2 None1 ADULTG lasgow Coma ScaleQualifiers: Patient Chemically Sedated Patient Intubated Obstruction to the Patients , GuidelinesStanford Hospital and ClinicsLucile Packard Children s Hospital Stanford Training ProgramsA-1 TABLE OF CONTENTSTRAUMA GUIDELINEPAGEP honeNumbers1-4 Trauma /ACS Rotation Goals & Expectations5-6 Trauma Nurse Practitioner Roles/Responsibilities7 Trauma Admission Policy8 Trauma Team Notification & Response9 Trauma Team Activation Code 99, 97, 9510-12 Trauma Resuscitation Roles13-20 Trauma Order Sets21 Clinical Trials & Prevention Programs22 Intervention (CAGE)
2 Programs23IV Access24 Massive Transfusion Guidelines25-26 Antibiotics in Trauma27-28 Airway Management29-30 Rapid Sequence Induction: Adult31-32 Head Injury Indications for CT33-36 Blunt CerebrovascularInjury (BCVI)37-38C-Spine Evaluation Adult39-40 TLS Spine Evaluation41 Trauma GUIDELINEPAGERib Fracture42 Penetrating Neck Trauma43-44 Blunt Aortic Injury45-46 Blunt Cardiac Injury47-48 Penetrating Chest Trauma to the BOX 49-50ED Thoracotomy (EDT)51-52 Hemothorax53-54 TruncalStab Wounds (Back, Flank, Abdomen)55-56 Blunt Abdominal Trauma57-58 Blunt SplenicTrauma59-60 Blunt Bowel and Mesenteric Injury61-62 Rectal Injury63-64 Pelvic Fracture65-66 Peripheral Vascular Injury67-68 Compartment Syndrome -Extremity69-70 Compartment Syndrome -Fasciotomy71 Trauma In Pregnancy72-73OB Trauma Response74 TABLE OF CONTENTSTABLE OF CONTENTSSICU GUIDELINEPAGES urgical Critical Care Policies75-78 Surgical Critical Care Call Triggers79 SICU Call Tree80 Commonly Used ICU Order Sets81 Emergency WarfarinReversal Protocol82 Management Severe TBI83 ICP Management84 Richmond Agitation Scale (RASS)
3 85 ARDS Ventilator Management86 empiric Antibiotics in the SICU Pneumonia87 empiric Antibiotics in the SICU Abdominal INFX88 empiric Antibiotics in the SICU Line Infections89 empiric Antibiotics in the SICU UTI/Urosepsis90 empiric Antibiotics in the SICU Sepsis91 DVT/PE Prophylaxis92-94 Critical Care Nutrition95-98 Brain Death99-100 ECMO101-102 Death Exam and Pronouncing a Patient103 PEDIATRIC Trauma GUIDELINESPAGEP ediatric Surgery & Trauma Contacts104 LPCHS Contacts105 Pediatric Trauma Inter-facility Transfers106 Pediatric Admissions to SHC & OR Determination107 LPCHS-OR Response to Stanford -OR108 Pediatric Massive Transfusion109 Pediatric Modified Rapid Sequence Intubation110-113 Pediatric Surgery Response to Trauma114NS and Ortho Emergent Response to ED115 LPCHS Roles & Response to Pediatric Trauma 99116-118ED to LPCHS-OR Notification Phone Call119ED to LPCHS-OR Emergent Transfer Hand-off120 Pediatric Trauma .
4 Doe Name & Blood Availability121ED to LPCHS Trauma Admission Guide122 Pediatric Trauma Hand-off for T99 & T97123 Pediatric Neurosurgery Consult124 Pediatric Head Trauma CT Decision125 Cervical Spine Clearance in Children after Trauma126-127 Pediatric Blunt Cerebrovascular Injury128-129 TABLE OF CONTENTSPEDIATRIC Trauma GUIDELINESPAGEP ediatric Blunt Spleen/Liver Trauma Management130-131 Pediatric Blunt Renal Trauma Management132-133 Pediatric Extremity Fracture134-135 Pediatric Pelvic Fracture136-137 Pediatric VTE138-139 Suspected Child Abuse and Neglect140 PICU Trauma Admission & Management141 Pediatric Trauma Pearls142 Lund-Browder Burn Percentages144 Pediatric Trauma Normal Vital Signs145 Pediatric Trauma -Weight in Kilograms146 Pediatric Trauma Estimated Blood Volume147 Pediatric Trauma G-Tubes, Chest Tubes, Foley148 Pediatric Trauma Laryngoscope, ETT, Suction149-150 TABLE OF CONTENTSAPPENDIXPAGELund-Browder Burn Percentages144 Pediatric Trauma Normal Vital Signs145 Pediatric Trauma -Weight in Kilograms146 Pediatric Trauma Estimated Blood Volume147 Pediatric Trauma G-Tubes, Chest Tubes, Foley148 Pediatric Trauma Laryngoscope, ETT.
5 Suction149-150 Solid Organ Grading Spleen151 Solid Organ Grading Liver152 Solid Organ Grading Kidney153 Solid Organ Grading Pancreas154 TABLE OF CONTENTST rauma/ICU AttendingsCellPagerJames Badger, MD650-740-070810850 Tim Browder, MD702-757-827623728 David Gregg, MD650-400-390110263 Javier Lorenzo, MDpager only24043 Paul Maggio, MD650-521-745313299 Paul Mohabir, MD650-804-481114318 David Spain, MD650-776-391223990 Kristan Staudenmayer, MD650-704-063123359 Tom Weiser, MD617-794-588723439 Sherry Wren, MD650-380-405813893 Trauma /ICU ContactsOffice/Pager SpectraSICU Fellow12989 (pager)SICU Senior Resident43085 SICU Junior Resident53234 Trauma Senior 49040 Trauma Floor Intern1216353245 Trauma Advanced Practice Providers.
6 -Jesse Alfaro, NP650-384-9507(cell)-Jessica Behrend, NP650-850-2446 (cell)-Mickey Claudius, NP650-213-6611 (cell)-Ya-Chen Lee, NP650-847-7154 (cell)-Courtney Nelson, PA650-847-9971 (cell) Trauma Case Manager (Michelle Paw)650-561-5501 Trauma Social Worker (Kate Aragon)650-475-6908 Trauma Nurse Coordinators-Denise Greci Robinson 925-784-3259 (cell)-Jo Ann Schumaker-Watt650-656-7979 (cell) Trauma Program Manager Shelly650-521-7613 (cell) Trauma Clinic Main Line650-723-6961 Trauma Services Office650-723-7570 Other ContactsSpectraBlue MICU33688 Green MICU68069 EmergencyAnesthesia67814 PHONE NUMBERS Trauma /ICU1 PHONE NUMBERS UnitsED3-7337E2/SICU 5-7122 North ICU(E29)3-6081OR 8-4318 PACU5-4834B14-0690B2 (Monitored)3-7101B3(Monitored)8-7442C1(A TU) 5-8106C1(CDU)4-1710C2( Trauma Floor Patients)3-5236C3 ( Medicine )3-7266D-ground (Pharmacy)5-4954D1(CCU)5-7111D1 (CSU)5-7114D1 (Pharmacy)5-5159D2(Monitored)5-7112D3(Mo nitored Trauma )5-7113 DGR(Ortho- Trauma )5-7110 Dialysis3-7585E15-7121E35-7123 EGR5-7120F15-7131F25-7132F35-7133 FGR3-7231G1 (Nsurg/NCOR)3-7136G23-6935G2S(Monitored)
7 4-3131H17-5800H23-5001 LPCH-OR1-2820 LPCH-PICU7-8850 Outpatient3-5274 Outpatient (Staff)3-33122 LabsABG 6-2127 Blood Bank3-6445 Core Lab2-5530 Echo3-7406 Microbiology4-4588 Surgical Pathology3-7211 Central Supply3-5272 RadiologyMain SHC3-6717 Bronchoscopy5-4654 Cath/Angio3-6738 Cath/Angio(Cancer Center) 5-3325 Colonoscopy/Endoscopy3-5919CT/GI3-6855CT Day Tech3-7573CT Night Tech1-9659ED Radiology Resident6-2107GI/Fluoroscopy3-6762IR5-36 15 Mammogram5-1323 MRI3-6335 MRI (after hrs tech)3-6335 Nuclear Med3-6884 XrayDay Tech1-5541 XrayEve Tech3-6717 XrayNight Tech1-9658 Ultrasound3-3498 PHONE NUMBERS Departments3 Main Operator3-4000 Page Operator 3-6661 SHC Admitting3-6221 Crisis Nurse1-6542ED Registration3-2248ED Resource RN4-2243ED Room 5 5-5096 Medical Records3-5721 Nursing Supervisor Pager1-6918 Nursing Supervisor Spectralink6-1767 PedsRadiology Hotline 07:00 17:00 days M-F 7-8757 After-hours/Weekends7-8758PT/OT8-7026 Speech1-5087 Transfer Center3-4696 or 800-800-1551 Surgical Clinics.
8 Trauma Clinic 3-6961 Orthopedic Clinic3-5643 ENT Clinic3-5281 Plastic Surgery Clinic3-7001 Neurosurgery Clinic3-6469 Vascular Surgery Clinic5-5227 PHONE NUMBERS Hospital45 Trauma /ACS ROTATION GOALS & EXPECTATIONST rauma Chief Resident (PGY-4):Goals: Primary responsibility for the management of all patients admitted to or evaluated by the team in conjunction with the attending surgeon Functions as the team leader, assuming direct responsibility for day-to-day care of patients on the service and coordinating care with consulting services Gain knowledge of surgical care through discussion on rounds with the attending and by independent reading Gain operative skills through pre-operative reading and preparation and by direct intra-operative teaching from attendingsExpectations.
9 Function as a team leader for daily patient care Attends all Trauma 97 and 99 activations Function effectively as Trauma captain or Trauma resident (if ED resident is captain) for Trauma resuscitations Ensures Trauma resident documentation is complete and timely for Trauma H&P s, daily notes, & discharges Notify Trauma attending of all Trauma 97 patients within 1 hour of evaluation and prior to any patient discharge from the ED Notify Trauma attending if any acute change in patient condition including ICU admissions, patient deaths, admissions, or discharges Attends Trauma clinic on Wednesday Attends General Surgery Clinic on Tuesday Prepare weekly case presentation for Monday Trauma conference.
10 Rev. 6/166 Trauma /ACS ROTATION GOALS & EXPECTATIONST rauma Junior Resident (PGY-1):Goals: Develops knowledge & experience in the evaluation and management of critically injured and ill surgical patients Gain knowledge of surgical care through discussion on rounds with the team and by independent reading Refine procedural skills commonly required for these patients Experience and understand the day-to-day function of a busy surgical service. Expectations: Interact with all members of team including ancillary and support staff in a productive, professional manner Execute the daily plans for the floor patients in a timely and efficient manner Assist in Trauma resuscitations Maintain appropriate documentation Notify Trauma chief resident of any significant change in patient condition immediately.
