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Emergency Room Trauma Procedures

Emergency room trauma patients are among the most severely injured, from incidents involving car accidents and cardiac arrests, to gunshot wounds and stabbings. Trauma patients require more specialized treatment than walk-in emergency room patients. Trauma specialists and other emergency room medical staff are trained in trauma policies and procedures, which contribute to saving lives in the critical first hour the trauma occurred, known as the golden hour.

  1. Trauma Triage and Transfer Procedure

    • Emergency room staff must immediately identify the patient, identify needed treatment and make decisions on whether treatment can be done in-house or if the patient will need to be transferred to another critical care facility. If a transfer is required, it needs to occur almost immediately to ensure the best possible recovery chances for the patient. The trauma level is also identified, which will determine the next immediate steps to take. There are three levels of trauma care: Level I, Level II and Level III. The highest and most extensive is Level I trauma. The initial hospital ER team works to stabilize the patient as directed by the emergency department physician. The ER physician contacts the receiving hospital to notify them of the patient's condition, constant status updates and confirms the receiving hospital is equipped to handle the patient's needs. If the trauma patient is not accompanied by a family member and cannot speak, the emergency medical technician will provide some of the patient's information. The registration desk requires the name of the patient, age, identification of injury, current condition and medical condition.

    Notification of Families Procedure

    • Emergency room trauma procedures include policy and guidelines regarding how hospital staff should contact the family of the trauma victim. Emergency room staff must be sensitive when communicating with each family member because of the sudden nature of the event and the family's response. Emergency department charge nurses can notify the trauma patient's family without the consent of the lead physician. This is the only instance where the nurse does not need the consent of the physician before contacting the family. Communication needs to be clear, detailed and repeated, if necessary, for proper clarification. The nurse will ask family members to repeat what was said to ensure they fully understand the information that was relayed.

    Discharge Preparation of Trauma Patient Procedure

    • Trauma patients are not discharged until their condition has been evaluated. Conditions that are monitored include the patient's physical ability and strength, cognition, range of motion and bodily functions. Patients must be showered and washed to remove all dirt, blood and other debris before being discharged. All wounds and injuries must be checked and examined thoroughly the day of discharge. The trauma patient is required to have a bowel movement. The trauma surgeon visits with the trauma patient, before discharge, to go over follow-up treatment, medications and home care.

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