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GRI ED Team Leader:______________________ Major Trauma Flow Sheet Date: DD/MM/YY Time ED: HH:MM Arrival – Transcribe from SAS PRF Mode SAS Self Stand-by SAS on scene HH:MM Yes EM Consultant Present? Yes No Trauma Team? Yes No Pre Arrival Trauma Team? Yes Attach Patient Sticker No PRIMARY SURVEY No SAS call HH:MM SAS left scene HH:MM Initial Observations EMRS HR c MIST RR BP Cleared Immobilised Clear RTC Mechanism (Circle) Driver Fall vs. FSP RSP Speed: Restrained Airbags Entrapped Ejection A Blunt Assault Crush Burns Other B Spontaneous Respiratory Effort? Yes CRIC OXYGEN N/DECOMPRESSION CHEST WALL CHEST DRAIN ED THORACOTOMY EXT HAEMORRHAGE RADIAL PULSE Treatment (Circle) HR BP RR Sp02 GCS E V M 02 IV Fluid Pelvic Binder Analgesia RSI Collar Scoop Airway Adjuncts ICD Other C Y N Details HH:MM ECG HH:MM Result CELOX ABDOMEN G&S / XM PELVIS PELVIC BINDER CENTRAL ACCESS TRANEXAMIC ACID GIVEN? (remember CRASH3 randomisation) AMPLE GCS Allergies D NKDA PUPILS E= LATERALISING SIGNS BM/GLUCOSE Other: TEMPERATURE ASA: Meal: LMP: Draft Nov 2014 Authors J Millar / D Lowe / D Maguire ßHCG: -ve +ve E LOG ROLL V= M= Equal and Reactive Warfarin / APT / NOACS PMHx Last TOURNIQUET HEART SOUNDS FEMURS Medications No RSI BREATH SOUNDS Injuries Initial SAS Observations PH ED TRACHEA Stab EVM Obstructed Adjunct NP ETT Guedel Height: GCS Sp02 Right Large Normal Flexor Left Large Extensor Unreactive No Response ACTIVE REWARMING Fluid BAIR NAD C SPINE T SPINE EXPOSED COMPLETELY? L SPINE PLAIN FILMS SECONDARY SURVEY STAFF C SPINE CHEST PELVIS OTHER: SPECICALTY TIME ED CONS HH:MM ANAES HH:MM ITU HH:MM RIGHT LUNG GEN SURG HH:MM LEFT LUNG ORTHO HH:MM PERICARDIAL PLASTICS HH:MM RUQ VASC HH:MM LUQ OTHER HH:MM PELVIS OTHER HH:MM E-FAST +VE -VE N/A GRADE Attach Patient Sticker NAME CT (Circle) WHOLE BODY CT HEAD BLOODS C SPINE CHEST ABDOMEN & PELVIS MAJOR HAEMORRHAGE PROTOCOL? Y OTHER N TIME HH:MM GAS 1 H+ pCO2 pO2 LAC BE HCO3 Hb Hct GAS 2 H+ pCO2 pO2 LAC BE HCO3 Hb Hct ROUTINE Hb Hct COAG INR Plt PT Na K Ur APTT INJURIES/MANAGEMENT 1 Cr Fibrinogen 2 DRUGS DRUG Tranexamic Acid DOSE ROUTE 1g IV PRESCRIBED GIVEN TIME 3 4 5 DISPOSITION Time HH:MM INPUT/OUTOUT CRYSTALLOID Millilitres BLOOD PRODUCTS : PRC Units FFP Units TOTAL Millilitres URINARY CATHETER Y / N Plt Pools Millilitres CHEST DRAIN Y / N RT Millilitres LT Millilitres SUCTION Millilitres FLOOR Millilitres TOTAL Millilitres THEATRE ICU HDU WARD MORTUARY COMPLETION NAME GRADE TIME
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