Pediatric Trauma Resuscitation: How We Do It Maria F. McMahon, RN, MSN, PNP-AC/PC Trauma Center Manager Boston Children’s Hospital
Struggles • Communication • Behavior in trauma room • Documentation of Attending arrival • Equipment • Fixation
Crisis Resource Management
CRM Principles • Role Clarity • Communication • Global Assessment • Resources • Personnel Support
How we do it • Role clarity – Pre-event huddle – Red line – Stickers
ED Attending ED Fellow/Resident SURGERY Attending SURGERY Resident/ NP Documenting RN
How we do it • Communication – Closed loop – Transparent – Tone – Event Manager
How we do it • Global Assessment – Dual event managers – Surgical Attending in house 24/7 – Trauma Check Point
How we do it • Personnel Support – Trauma Nurse Leaders – Parent presence – Red line
How we do it • Resources – Web based image sharing – CT scanner location – ID scanner – Color coded equipment – Limit labs and diagnostics
Trauma Crisis Resource Management (CRM) • Mandatory • Multidisciplinary • Case-based • In-situ
Ongoing Improvement • Self-debriefing with feedback after each scenario • Trauma Nurse Leaders review all high level trauma activations • Changes based on feedback from mock resuscitations and real-time resuscitations – Quantitative – Neuro STAT, MTP – Qualitative
Questions?
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