Educational Objectives (PGY 1-2)
- 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:
- Insert an oropharyngeal/nasopharyngeal airway.
- Perform a cricothyroidotomy, tracheal puncture and tracheostomy
- Obtain vascular access, including peripheral venous access, central venous access (femoral, subclavian, internal jugular), and insertion of intraosseous vascular device.
- Needle thoracostomy and Insertion of a thoracostomy tube
- 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
- 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
- Manage own time, education and personal life to ensure balanced lifestyle
- 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
- 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
- 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