Criteria for early notification of trauma for interfacility transfer1
ALL trauma patients - do rapid assessment of vital signs, injuries and mechanism of
... [Show More] injury
Adult Newborn
< 4 weeks
Infant
1 - 12 mths
Child
1 - 8 years
Child
9 - 15 years
Respiratory rate/min < 10 or > 30 < 40 or > 60 < 20 or > 50 < 20 or > 35 < 15 or > 25
O
2
saturation in room air < 90% < 95% < 95% < 95% < 95%
Systolic BP mmHg < 90 n/a < 60 < 70 < 80
HR/min > 120 < 100 or > 170 < 90 or > 170 < 75 or > 130 < 65 or > 120
GCS < 14 Altered LOC Altered LOC Altered LOC Altered LOC
Vital signs
• All penetrating injuries
– head/neck/chest/abdomen/pelvis/axilla
• Blunt injuries
– patients with significant injuries to a single region - head/neck/chest/abdomen/pelvis/axilla
– patients with injuries involving 2 or more of the above body regions
• Specific injuries
– limb amputation/life threatening injuries
– suspected spinal cord injuries
– burns: adult > 20% total body surface area (TBSA), child > 10% TBSA
– suspected respiratory tract burns
– serious crush injury
– major compound fractures or open dislocation
– fracture to 2 or more: femur, tibia, humerus
– fractured pelvis
Injuries
• Ejection from vehicle
• Motorcyclist impact > 30 kph
• High speed motor vehicle collision > 60 kph
• Vehicle roll over
• Fatality in same vehicle
• Prolonged extrication > 30 minutes
• Pedestrian impact
• Fall from height > 3 metres
• Struck on head by falling object > 3 metres
• Explosion
Mechanism of injury
If ANY of the above are present PROMPTLY CALL
RSQ 1300 799 127
for management support, retrieval advice and destination decision
or your local/state trauma escalation service
If none of the above is present, follow usual local processes for assessment and transfer of the patientCopyright
Copyright i
The Primary Clinical Care Manual 10th edition 2019
ISBN: 978-1-876560-05-8
© State of Queensland (Queensland Health) 2017 and the Royal Flying Doctor Service (Queensland Section)
Comments and feedback
Comments and feedback to this edition are welcome. Please write or email:
Executive Director
Rural and Remote Clinical Support Unit
PO Box 7193
Cairns, Queensland 4870
[email protected]
Head of Clinical Governance
Royal Flying Doctor Service (Queensland Section)
12 Casuarina Street
Brisbane Airport, Queensland 4006
[email protected]
Suggested citation
Queensland Health, Royal Flying Doctor Service (Queensland Section), Primary Clinical Care Manual 10th
edition 2019, the Rural and Remote Clinical Support Unit, Torres and Cape Hospital and Health Service,
Cairns
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The Primary Clinical Care Manual 10th edition 2019 is distributed by Queensland Health and the
Royal Flying Doctor Service (Queensland Section) as an information source only and does not replace
clinical judgment. The information is provided solely on the basis that readers will be responsible for
making their own assessment of the matters presented herein and readers are advised to verify all relevant
representations, statements and information. The information does not constitute clinical advice and
should not be relied upon as such. Specialist advice in relation to the application of the information
presented in this publication must be sought as necessary to ensure the application is clinically appropriate
In no event shall Queensland Health or the Royal Flying Doctor Service of Australia (Queensland Section)
be liable (including liability for negligence) for any claim, action, proceeding, demand, liability, costs,
damages, expenses or loss (including without limitation, direct, indirect, punitive, special or
consequential) whatsoever brought against or made upon or incurred by Queensland Health or the Royal
Flying Doctor Service of Australia (Queensland Section) arising out of or in connection with a person's use of
or reliance on or inability to use the information or instructions provided in this publication, or incorporated
into this publication by referenceContents
ii | Primary Clinical Care Manual 10th edition |
Contents
Endorsements x
Acknowledgements 1
Introduction 7
Endorsing the PCCM in Queensland 7
The PCCM and collaborative practice 7
Recognising and responding to clinical deterioration (RRCD) in acute health care 8
Authority to administer and supply medicines 9
Health Management Protocols and Clinical Care Guidelines 10
What's new in this edition 13
1. Patient assessment and transport 17
Patient presentation - adult and child 19
Adult presentation 20
Clinical consultation 28
Patient retrieval/evacuation 29
2. Pain, nausea and vomiting 33
Acute pain management 35
Nausea and vomiting 48
3. Emergency 53
Resuscitation 54
DRS ABCD resuscitation/the collapsed patient 54
Advanced life support (ALS) 56
Oxygen delivery 64
Laryngeal mask airway (LMA) insertion 67
Intraosseous infusion 69
Critical emergencies 73
Unconscious/altered level of consciousness 73
Shock 77
Sepsis/septic shock 80
Meningitis 91
Foreign body airway obstruction (choking) 99
Anaphylaxis 102
Fits/convulsions/seizures 109
Hyperglycaemia 113
Hypoglycaemia 115
Acute asthma 119
Drowning/submersion 128
Cardiovascular emergencies [Show Less]