ER Staff Meeting Trauma Update January 2017 Zach Stanford, RN, CCRN, TCRN, CEN Trauma Education

Kris’ prediction for 2016 Trauma Stats

Trauma Education 2017 The registration links for TCRN and TNCC are active and working. TCAR and ENPC links are still in progress. As class registrations “open” and become active I’ll let you know.

Critical Care Pot Luck We are teaming up with ICU for this 4 CE course that will cover a pot luck variety of critical care topics. Sign-up sheet is posted in the break room. If people would like to bring pot luck food items that is great, if not that’s great too. If our 15 spots fill up and you would like to come let me know and I will start a waitlist and we will see if and how we can accommodate.

What Triggers a Trauma Chart Audit? Trauma Chart Audit Fields

“Just in time Audit” sheets This page is attached to some of the trauma sheets. The purpose is to: Increase awareness Act as another reminder to check your chart for missing information before you turn it in. When your trauma patient has been admitted, discharged or you have transitioned to EPIC review this page. After you have verified that your paper charting is complete, initial and turn in with the trauma flow sheet

How can I avoid the audit emails? If you transition to EPIC, close your “paper” trauma chart! Top 5 areas that are missed: Total Intake/Output (total it to that point in time – just like a shift change) IV –Size / site / fluids C-Collar removal (or placement of Aspen) Level of activation (alpha, bravo, limited) Narrative (This is a chance for you to tell the ‘story’ that is not or can not be told by the check boxes. This helps reflect the level/quality of your nursing care) “I knew I should’ve brought a pen to work!” ***Trauma Chart Audits are ONLY done on the PAPER chart – NOT on the EPIC charting***

Trauma Ed Highlight Anticipate Pelvic x-rays on MVC and MCC traumas For all high impact MVC and MCC double check with Trauma Surgeon about the addition of pelvic x-ray before CT Anticipate Pelvic x-rays on MVC and MCC traumas

Trauma Ed Highlight Just because a trauma patient has been triaged out of the trauma room does NOT necessarily mean they are stable or low acuity… ALWAYS have a high index of suspicion A nurse is to accompany ALL monitored Trauma patients to CT or MRI Cervical cord compression on MRI with a ‘normal CT’ Right intraparenchymal bleed on CT

Trauma Ed Highlight All trauma patients are to be on a monitor Exceptions to the rule: Flagged for discharge Have an order to d/c telemetry Have a disposition for a non-telemetry admission All trauma patients are to be on a monitor