1. 2018 Trauma Care Update PRESIDENT ELECT
Prof. Lisa Moreno-Walton, MD, MS, MSCR, FAAEM, FACEP
PROFESSOR of Emergency Medicine
Director of: Research, Diversity, Viral Testing
Section of Emergency Medicine
Director of Latino Scholars Program
Louisiana State University Health Sciences Center- New Orleans
PRESIDENT ELECT
AMERICAN ACADEMY OF EMERGENCY MEDICINE

2. Disclosures
Dr. Moreno receives research funding from Gilead Sciences, Inc. There will be no discussion of any Gilead products, however there will be discussion of peer reviewed articles on HIV infection.
Disclosures:
I do receive research funding, directly or indirectly, from several government agencies
NIH- NIAA
CDC
LSUHSC Dean’s Research Program
LSUHSC Translational Research Fund
Alpha Omega Alpha Honor Society
I am a National Institutes of Health PRIDE Research Scholar
I may in future receive royalties from Springer Publishing Company for the sales of my book “Diversity and Inclusion in Quality Patient Care”

3. Objectives
To cover the new evidence based updates in trauma care as recommended by the American College of Surgeons Committee on Trauma Advanced Trauma Life Support Course.

4. Initial Assessment One liter of crystalloid only (not 1-2)
Move to blood quickly for non-responders
Tranexamic Acid

5. Shock
Give 1:1:1 blood products as part of the massive transfusion protocol
New standards for signs and sx of hemorrhage
Emphasis on base deficit

7. Thorax Use US to identify PTX
New site for needle decompression is the 5th intercostal space in adults
New recommended chest tube size is F, which replaces F

8. Traumatic Cardiac Arrest Algorithm
BRAND NEW!

11. Pelvis
High riding prostate is NOT reliable to determine urethral injury
Consider pre-peritoneal packing in ED to control bleeding.

13. Head Trauma Anti-coagulation reversal guidance
Recommendations for protamine, vitamin K, platelets, etc which are standard recommendations put into a chart
Clarification but no change in GCS scores

14. Spine and Spinal Cord Diagram for key dermatomes and myotomes included
Backboard awareness (> 2 hours results in ulcers)
Endorsement of NEXUS and Canadian C-spine rules
Neuro deficit
Etoh or other intoxication
X-treme distracting injury
Unable to provide history (AMS)
Spinal tenderness in the midline
Spinal motion restriction as opposed to immobilization

15. Musculoskeletal
Resurgence of the tourniquet

16. Transfer No CT at transferring hospital
Do not do any studies that will not change care at transferring hospital
ABC- SBAR
Airway
Breathing
Circulation
Situation- pt ID, reason for transfer, IV access, tx so far
Background- Event hx, AMPLE, blood products, interventions, response
Assessment- VS, PE, response to tx
Recommendations- type of transfer, type of tx

17. BETTER CARE THROUGH USE OF EVIDENCE!
SAVING LIVES IN 2018