Talking Trauma

In the most recently published Victorian State Trauma Registry report, 39% of all trauma cases were transport related. Trauma prevention and road safety continues to play a huge part in the reduction of major trauma in Victoria and today we are joined by Samantha Cockfield, Head of Road Safety for the Transport Accident Commission (TAC) to provide insight into current issues facing Victorian road users and the role of the TAC. Current at date of publication 14/01/2021.

Victims of major trauma have a varied profile, including age, demographic & geographic location. Today Danielle speaks with Melissa Webb, trauma and orthopaedic allied health team leader at The Alfred Hospital to gain an understanding of the importance of a multidisciplinary approach to care and consider rehab and planning beginning from the roadside. Current at date of publication 04/01/2021.

Children are vulnerable to injury for a number of reasons with motor vehicle collisions (MVC’S) accounting for almost half of the fatalities in children. In Victoria, the Paediatric Infant Perinatal Emergency Retrieval (PIPER) service is available to retrieve critically injured children from referring hospitals and provide safe, expert, emergency inter-hospital care. Today we speak with Dr Sile Smith, a Paediatric Intensive Care Consultant from the Royal Children’s Hospital and Medical Co-lead for PIPER about the role PIPER has in Paediatric Major Trauma. Current at date of publication 28/12/2020.

Emergency management of a difficult airway in the major trauma patient is always a daunting task. Complications may arise as a result of emergency intubations, but failure or delay in securing an adequate airway may contribute to unacceptably high morbidity and mortality rates. Today we are talking to Dr Peter Fritz, Consultant Emergency Physician at The Alfred Hospital about Airway Management in the trauma patient. Current at date of Publication 21/12/2020.

Early specialist care of Spinal Cord Injury (SCI) can have a significant effect on long-term outcomes for these patients. The natural progression of SCI, in particular rising spinal cord oedema, may lead to an exacerbation of symptoms in the hours following an accident. Today we speak with Associate Professor Andrew Nunn, Director of the Victorian Spinal Cord Services at Austin Health who provides insight into early management of the patient suffering a potential spinal injury. Current at date of publication 21/12/2020.

The Victorian State Trauma System is one of the best in the world, with Adult Retrieval Victoria playing a significant role in making this a success. Today Danielle talks with Dr David Anderson, Acting Medical Director of Ambulance Victoria and an Intensivist at The Alfred Hospital to discuss how Adult Retrieval Victoria (ARV) operates within the state trauma system and gives you an inside look into behind the scenes of coordinating the care and retrieval of a major trauma patient. Current at date of publication 7/12/2020.

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.

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.

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.

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 the Thoracic Surgery Service at Royal Melbourne Hospital to discuss early identification & management of traumatic chest injuries

Early management of traumatic brain injury incorporates minimising secondary brain injury by avoiding periods of hypoxia, hypotension and applying management principles to support 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 morbidity and mortality in Australia. Current at date of publication 08/08/2020. 

Trauma patients are predisposed to hypothermia for a variety of reasons including exposure to the environment and disordered homeostasis. Patients who remain hypothermic are at risk of developing serious sequalae such as acidosis and coagulopathy resulting in an 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.

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.

Stopping the bleeding following trauma is of paramount importance in the critical first moments after 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.

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 assessment, with a focus on the initial identification and management of injuries. Current at date of publication 29/05/2020.

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.

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.

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.

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.

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.