02/18/2020
Special Operations Medic Coalition
How many SOF Medics have set this up and how?
@somcoalition lessons learned coming soon!
Reposted from @the_resuscitationist .
TRAUMA TEAM ORGANIZATION AND TEAM LEADER PERSPECTIVE.
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This concept is commonly overlooked & undervalued. My team has out the effort in to understand eachother roles and responsibilities. .
IMAGE: just one example of set up. Theres no "one/ right way"
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PREARRIVAL: assign roles and expectations. Have equipment ready, blood bank called, adjunct resources and meds gathered and assisting services notified (RT, XRAY, subspecialties etc)
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HEAD OF BED: someone well versed with airway management (anesthesia, ed doc, crna). Able to start primary survey of Airway+Breathing. Then gather AMPLE history, control Cspine and start head/neck/upper chest secondary survey. Should call out airway and breathing findings.
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RIGHT SIDE: get IV access, draw first labs, check that side of chest/abdomen. Should call out type of IV and location .
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LEFT SIDE: get IV access, place on monitor, check that side for injury, physical exam. Begin to call out vitals and type/location of access.
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EXTRA MEDIC/NURSE #1: cut off clothing, apply C-Collar or pelvic binder
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EXTRA MEDIC/NURSE #2: cut off clothing, assist with getting backboard, gather medications
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EXTRA MEDIC/NURSE #3: run belmont, get fluids, accessory needs.
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NOTE: the number of extra hands can be variable based on location and resources. Sometimes too many in the trauma bay gets chaotic.
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TEAM LEAD: I prefer foot of bed. It allows me to get "the big picture". Also close to EMS and nursing station to relay communication. Team lead is like a musical conductor. They lead the team through the primary and secondary surveys (M.A.R.C.H). I will call back what the other team members say (closed loop communication) keep the appropriate tempo and gather/interpret information as it appears. Typically responsible for advanced procedures (chest tubes, central lines, running MTP etc) & decision making. I routinely take off shoes, feel distal pulses and check pelvis/pubic symphesis, and back when rolling patient. If no one else trained, team lead also does EFAST.
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Training Fairfax County EMS Providers since 2005.
