Upstate University - Trauma Center - Virtual Tour

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The Golden Hour of Trauma Care

The purpose of this is to give an overview of the resuscitative phase of trauma care and is not intended to provide step-by-step directions for accomplishing the associated tasks.

Radio Room

Radio Room

Incoming EMS calls are received on the radio or on a telephone line. Calls are answered by an ER physician. ER physician or Nurse activates the trauma code.

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Video: Video Test
Donning PPE - Video Version
Donning PPE - Still Version

Donning PPE - Still Version

PPE consists of: Gown, Gloves, Mask, Eye Protection

Trauma Positions

Trauma Positions

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Team Leader

The team leader is responsible for guiding the team and overall management of the patient. Seeks input from team members.

Support/Procedure Staff

HCT – Is an RN for level 1 TTA. Can be an LPN or HCT for level 2 TTA. Responsible for tasks which will vary with credentials. Examples include manual blood pressure, log-rolling patient and applying monitor for transport.

Airway Physician

An Airway Physician is responsible for managing airway, determining medications for intubation, and will perform primary and secondary assessments as they pertain to head and neck

Primary Nurse

A Primary Nurse – RN, assists with procedures, establishes IV’s, administers medications, etc.

Scribe Nurse

A Scribe nurse documents care of the patient including the EMS report, patient assessment, procedures performed and results of all treatments.

Procedure Physician

A Procedure physician performs surgical procedures on this side of the patient. Position is at the side of the trauma stretcher, next to the primary nurse

Assessment Physician

The Assessment Physician coordinates overall assessments. And performs physician or surgical procedures on this side of patient.

Trauma Room

Trauma Room

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Storage room

Contains procedural trays and blanket warmer.

Pyxis Medication Machine

For medication dispensing.

Belmont Rapid Infuser

Used to warm and rapidly infuse blood.

TV Monitor

For viewing images from portable x-ray machine.

Scribe Computer

Used to document on patient in trauma narrator.


For specific patient information viewing

Trauma Supply Carts

Contains equipment and supplies for use during a trauma code.


Fiber optic laryngoscope.

Difficult Airway Cart

Cardiac Monitor

Can also be used for oxygen saturation, temperature, and end tidal CO2.

Floor Circles

Blood Refrigerator

Containing 2 units O Negative Blood


Stretcher/Slider Board

Equipment and Supply Omnicell

Items include, but not limited to cervical collars, thoracotomy supplies, REBOA, and central line kits.

Ultrasound Machine for FAST exam

PPE supplies and role stickers


Used by Residents and Advanced Practitioners to document and enter physician orders

Broselow Cart

MIST Hand-Off
Primary Assessment

Primary Assessment

The primary assessment looks to identify and correct life-threatening emergencies in the order that they are found. The CABCDE approach is utilized.

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The CABCDE Approach

C = Uncontrolled External Hemorrhage
External hemorrhage will be controlled with the use of direct pressure, wound packing, and/or placement of a tourniquet. Initial fluid/blood resuscitation is started.

A = Alertness and Airway
The airway must be secured prior to assessing breathing. Interventions may include endotracheal intubation, or placement of a surgical airway.

B = Breathing
Adequate oxygenation and ventilation are extremely important. Supplemental oxygen is often needed and administered via mask or ventilator if patient is intubated. Tension pneumothoraces and massive hemothoraces are life-threatening and require chest tube placement prior to assessing circulation.

C = Circulation
Fluid/blood replacement is initiated (exception of uncontrolled external hemorrhage where this is started prior to airway).

D = Disability
Assesses the neurological status of the patient. Includes Glascow Coma Scale (GCS) and movement and sensation in the extremities.

E = Exposure and Environment
Patient needs to be completely exposed to look for injuries. Body temperature must be maintained as hypothermic patients can become coagulopathic. Methods to maintain room temperature include closing the door and increasing ambient room temperature; warm blankets and/or warmed IV fluids or blood.

Adjuncts to the primary survey include chest x-ray, pelvic x-ray, and FAST exam.

A pelvic binder should be placed at this time for evidence of an open-book fracture.

Secondary Assessment

Secondary Assessment

Composed of head to toe assessment, patient history, and vital signs. Patient History: obtained from available resources. SAMPLE history or similar can be used to obtained the history.

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SAMPLE History

S = signs or symptoms
A = allergies
M = medications
P = Past Medical History
L = last oral intake
E = events leading up to the current presentation (history of presenting injury or illness).

Vital Signs-complete set of vital signs, including Glascow Coma Scale (GCS).

Head-to-toe assessment is the systematic assessment of the patient looking for abnormalities. After the completion of the head-to-toe assessment, treatment is prioritized based upon severity of the injuries found.



Based on patient stability, disposition may include CT scan, SICU, Interventional Radiology, OR, or medical/surgical floor. There is a Fast-Track policy for patients who need ongoing critical care. This helps expedite transfer of the patient to definitive care.

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