Trauma Rotation

Educational Objectives (PGY 1-2)

MEDICAL EXPERT:

  • Apply the principles of ATLS, including primary survey, resuscitation, secondary survey and adjuncts/investigations
  • Identify the clinical setting in which airway obstruction is likely to occur and recognize the symptoms and signs of airway obstruction when it does occur
  • Outline the various techniques to maintain an airway in a trauma patient, including endotracheal intubation and cricothyroidotomy, and have a working knowledge of when these techniques should be applied
  • Define shock and have a working classification of shock
  • Develop an applied understanding of the symptoms and signs of patients presenting with shock and know how to differentiate the various etiologies of shock, including hypovolemic, septic, cardiogenic and neurogenic
  • Develop an applied understanding of the treatment of hemorrhagic shock, and know the clinical indicators of response to therapy
  • Recognize the symptoms and signs, and initiate treatment for the following injuries: airway obstruction, pulmonary contusion, simple/tension/open pneumothorax, flail chest, simple/massive hemothorax, and cardiac tamponade
  • Recognize the signs suggestive of intraperitoneal, retroperitoneal and pelvic injury, including guarding, rebound, flank hematoma, perineal hematoma, etc.
  • Know the indications for and be able to interpret the results of DPL, ultrasound and trauma CT scans
  • Develop and applied understanding of the initial management of musculoskeletal trauma, including ordering initial investigations, immobilization and assessment of neurovascular integrity
  • Recognize patients where tetanus prophylaxis is warranted in the trauma patient.
  • Perform the following skills:
    1. Insert an oropharyngeal/nasopharyngeal airway.
    2. Perform a cricothyroidotomy, tracheal puncture and tracheostomy
    3. Obtain vascular access, including peripheral venous access, central venous access (femoral, subclavian, internal jugular), and insertion of intraosseous vascular device.
    4. Needle thoracostomy and Insertion of a thoracostomy tube

COMMUNICATOR:

  • Establish therapeutic relationships with patients and their families in the clinic, emergency room and on the inpatient units.
  • Communicate effectively with patients and families in order to obtain through, focused histories during patient care encounters
  • Present consultations including detailed history, physical exam and findings of investigations to senior residents and attending staff.
  • Document consultations including history, physical examination, findings of investigations and outline of the management plan (both written and dictated as appropriate).
  • Update patients and family relevant information regarding their condition and management plan with appropriate supervision

COLLABORATOR:

  • Work/collaborate effectively as a member of the interdisciplinary care team, fostering a positive team environment
  • Consult other medical and surgical specialities appropriately in the care of the patients
  • Demonstrate a safe and accurate written and/or verbal handover of patient issues to colleagues
  • Listen and respond appropriately to concerns of other health care providers

LEADER:

  • Manage own time, education and personal life to ensure balanced lifestyle

HEALTH ADVOCATE:

  • Recognize and respond to determinants of health in trauma including substance abuse and socio-economic status
  • Facilitate improvements in the underlying determinants of health in trauma patients in an integrated fashion during care delivery
  • Facilitate return of patient to community/alternate care environments in collaboration with the multidisciplinary care team and advocate for access to resources
  • Identify and provide community care/resources to support patients during their medical journey

SCHOLAR:

  • Actively participate in weekly rounds/educational activities
  • Identify and seek out personal learning needs related to cases encountered on the trauma service
  • Facilitate patient, student and peer learning

PROFESSIONAL:

  • Foster collegial relationships with staff and residents, nurses and other allied health professionals
  • Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, timeliness, respect and altruism
  • Show appropriate respect for opinions of other health care providers
  • Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively