Trauma Care: Beyond the Trauma Bay

Critical Aspects of Post-Resuscitation Trauma Care

Care of patients with traumatic injuries usually starts in the trauma bay of a designated trauma center, but that’s just the beginning. After initial resuscitation, these patients are typically transferred to critical care or progressive care units, where unique manifestations of trauma often emerge hours or days later. Providing safe, effective post-resuscitation care for patients experiencing trauma involves a complex balance of competing priorities and interdependent needs.

Ongoing, Vigilant Assessment

To prevent or mitigate trauma complications, watch for missed injuries, sepsis and the “lethal triad” of acidosis, coagulopathy and hypothermia.

Psychosocial Patient and Family Support

Trauma is sudden and unexpected, perhaps forever changing patients’ and families’ lives. Offer supportive resources, including patient/family education, to foster optimal outcomes.

Proper Body Positioning and Early Mobility

Traumatic injuries can impede correct body positioning. Initiate early mobilization to help avoid complications such as pressure injuries, respiratory infections and delirium.

Evaluation for Transition to Next-Level Care

Readiness to transfer to the next level of care is a critical step in a patient’s recovery from trauma. Conduct collaborative evaluations with the patient, family and care team.

Key Resources for Trauma Care

AACN recognizes the challenges that ICU and PCU nurses face in providing optimal post-resuscitation care to patients with traumatic injuries and offers the following featured resources to support your practice.

Case Studies in Geriatric Trauma

Explore current evidence and best practices in this discussion about providing optimal, quality care to older patients experiencing trauma from admission to discharge.

Picking Up the Pieces: Case Studies in Pediatric Trauma

Discover common causes of pediatric trauma related to developmental age and a collaborative approach to care.

Focused Assessment With Sonography for Trauma (FAST)

Learn about this diagnostic tool for trauma situations requiring rapid, noninvasive and accurate assessment.

Septic Emboli Resulting From Severe Trauma: A Primer on Care

Delve into the layered, time-sensitive nature of trauma care — diagnoses, complications, mortality risks.

Pain Control and Opioid Use in Trauma Patients

Review the efficacy, safety and availability of opioid-sparing therapies and pain regimens that reduce pain and decrease opioid abuse.

Trauma-Informed Care: Pediatric ICU Nurses and Children’s Safety/Trust

Stay current on trauma-informed care and its application for the pediatric ICU.

Webinar Series: Key Concepts for Trauma Care in the ICU and PCU

AACN’s three-part trauma care webinar series is designed to provide progressive and critical care nurses — whether or not they work in a designated trauma center — with essential information to safely and effectively treat post-resuscitation patients with traumatic injuries.

Part 1

Presents foundational knowledge to understand the basics of trauma care and resuscitation for nurses in the ICU and PCU

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Part 2

Builds on learning from Part 1 to address post-resuscitation care of patients with upper-body traumatic injuries: brain, spinal cord and upper torso

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Part 3

Continues the body systems approach from Part 2 with a focus on lower-body traumatic injuries: abdominal, pelvic and long bone

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Trauma resuscitation is a process that often continues to the inpatient unit. Patients experiencing trauma with multisystem injuries require complex interventions, usually with competing priorities.
John Gallagher, DNP, RN, CCNS, CCRN, TCRN, CHSE, RRT, FAAN, FCCM

Trauma Update Symposium Series

The articles in this symposium series — featured in AACN’s peer-reviewed quarterly journal, AACN Advanced Critical Care — provide updates in key areas of trauma care to support the practice of advanced practice nurses, direct care nurses and other healthcare professionals.

Trauma Update Symposium Introduction

Reviews the evidence driving practice change in trauma care and its application in critical care and intermediate care settings

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Traumatic Brain Injury Update

Addresses multimodal neuromonitoring in a narrative review, with a discussion of tools and techniques used in the treatment of patients with brain injury

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Hemostatic Strategies in Trauma

Explores the pathophysiology of trauma-induced coagulopathy, evidence-based techniques to evaluate hemorrhage and strategies to promote hemostasis

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Critical Care Considerations for Damage Control in a Trauma Patient

Presents basic principles of damage control surgery and resuscitation in the ICU, including potential complications

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In-Depth Course: Trauma Care After Resuscitation

This online course presented by Visionem addresses the learning needs of nurses and other clinicians who care for trauma patients in settings after the resuscitative phase. The course will help you anticipate injuries, recognize patient deterioration, prevent complications, identify assessment strategies, initiate interventions and evaluate outcomes in hospitalized patients with traumatic injuries.

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