1. TRAUMA ACTIVATION TIMELINE
Pre-arrival
T=0
Arrival
T+0
Immediate Actions
T+5
After Arrival
T+10
T+20
Trauma Activation
Activate Trauma Call / Alert
Consider Obs / Neonatal
Consider MEP
Assemble Team
Ensure all team present
Role allocation & label
Lead gown & PPE
Team Brief
Share prehospital information
Formulate management priorities
Get Ready
Equipment & Drugs
Pre-scrubbed Proceduralist
Crowd Control
Initial Assessment
Patent airway
Central pulse
No visible active haemorrhage
Ambulance Handover
Transfer to ED trolley
Silence during handover
IMIST/ISBAR format
Treat immediate life threats
Concurrent Primary Survey & Immediate Treatment
C  Control Exsanguinating Haemorrhage
 2x large iv access (peripheral > RIC/CVC > IO)
C  Shock: commence MEP
 ?Cardiac tamponade > US > ?thoracotomy
 ?Pelvic fracture > pelvic binder
 Long bone # > splint & assess vascular supply
A  Actual or impending airway compromise >
 O2 / airway manoeuvres > BVM > intubation
D  Combative patient > Intubation
B  Ventilatory failure > O2 / consider intubation
 US > finger thoracostomy for tension PTX
Non Invasive monitoring & 3 lead ECG
Review Primary Survey
Reassess ABCD
Treat as necessary
Imaging
CXR, PXR
eFAST
Trauma bloods / Xmatch / ROTEM
Analgesia
Situational Update
Immediate CT versus transfer to OT/IR
Set goals on physiology
Secondary Survey
May be performed if patient does not require time critical intervention
Prepare for transfer
Reassess splints/dressings
Secure lines
Check equipment
Command Huddle
Decisions on next steps made by senior members of team
Communicated to whole team
Confirm Drugs
Analgesia
Antibiotics
Tetanus prophylaxis
Inform Family
The TTL, a senior nurse and social worker will explain the situation to the patient’s family