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Trauma Tertiary Survey
A tertiary survey (exam) should be performed on all patients admitted to the trauma service approximately 24 hours following admission/initial evaluation. The tertiary survey is a repeat head-to-toe examination of the trauma patient that is designed to iden...
Massive Transfusion for Trauma Protocol
Purpose Hemorrhage is the leading cause of early death following traumatic injury. Protocol-driven transfusion strategies that approach a 1:1:1 ratio in patients who require massive transfusion improve patient survival, reduce hospital and ICU length of stay,...
e-FAST for Trauma
Purpose To standardize the application of e-FAST in the seriously injured patient, the technique employed, and the quality of standards by which they are retrospectively evaluated. Background e-FAST is a valuable diagnostic tool in the evaluation of trauma...
Daily Floor Rounding Checklist for Trauma Patients
Forensic Examiner Program Nebraska Medicine
Care of Patients with Rib Fractures
Purpose Rib fractures occur in approximately 10% of patients with traumatic injury. They are associated with greater injury burden especially when coupled with head, extremity, abdominal and blunt cardiac injury. Mortality rates increase with the number of fr...
Surgical Stabilization of Rib Fractures (SSRF or Rib Plating)
Purpose Surgical Stabilization of rib fractures should be considered in patients with flail chest, flail sternum, and painful rib fractures associated with movement that have been refractory to conventional pain management in order to improve morbidity and mo...
Management of Open Fractures
Purpose Open fractures are high energy injuries that have increased risk of infection due to potential exposure of bone and deep tissue to a variety of environmental debris. Infection can lead to serious complications including nonunion of wounds and osteomye...
Management of the Pregnant Trauma Patient
Purpose: Pregnancy alters baseline physiology and anatomy. These changes can influence the evaluation of a traumatically injured pregnant patient. The signs and symptoms of injury can be confusing. The pregnant patient has abnormal baseline laboratory ...
Care of Trauma Patient with Accidental Hypothermia Practice Guidelines
Purpose: The purpose of this practice guideline is to provide guidance and standardize the approach to the management of trauma patients with accidental hypothermia. Definition: Hypothermia is defined as the involuntary drop of core temperature below 36°C...
Indications to Consult Physiatry (PMR)
Purpose To identify criteria for early physiatry (PMR) consultation and expertise on the multidisciplinary trauma care team following admission. PMR Consult Service The PMR consult service is ran by Dr. Dan Pierce. He is available to see consults on patien...
Indications for Geriatric Consultation In Trauma Patients
Purpose Identify criteria for early geriatric consultation and geriatric expertise on the multidisciplinary trauma care team at the time of admission in order to optimize care of geriatric trauma patients throughout his/her hospital stay. Criteria for Consu...
Important Phone Numbers and Contact Information
Acute Care Surgery Attendings: Attending Pager Cell Office Zachary Bauman, DO 402-888-1131 712-251-0895 402-559-4714 Joseph Baus, MD 402-888-1800 614-975-5466 N/A Christopher Barrett, MD 402-888-6080 651-497-7846 402-559...
Trauma Quality Indicators
Background: From the time a trauma patient is picked up by EMS on scene through the patient's initial assessment, hospital course, and discharge, our trauma program is carefully monitoring each patient and collecting data. Data collected includes demographic ...
Evaluation and Management of Blunt Splenic Injury
Purpose Splenic injury is one of the most common injuries following blunt abdominal trauma and can result in significant bleeding given the vascular nature of this organ. Unrecognized injury can be a cause of preventable death following trauma. The following ...
Advanced Care Planning and Palliative Care Consultation in Acute Care Surgery
Purpose · To engage injured or ill patient’s and/or families in discussions regarding goals of care and advanced care planning early and provide guidelines for Palliative Care consultation to assist in facilitating discussions surrounding goals of care ...
VTE Prophylaxis in Trauma Patients
Purpose Venous thromboembolism (VTE), in the form of either deep vein thrombosis (DVT) or pulmonary embolism (PE), can result in significantly increased morbidity and mortality for patients. Trauma patients, in particular, are at increased risk for developmen...
Adult ICU Electrolyte Replacement
Purpose To define patients eligible for the electrolyte replacement protocol; to define the process for a provider to order the electrolyte replacement protocol; for a nurse to order and administer electrolyte replacement using this protocol; for a pharmacis...
Assessing Capacity
Why assess capacity? Informed consent promotes individual autonomy and fosters rational decision-making, and is founded on the right of self-determination and physician’s fiduciary responsibility to the patient. Informed consent requires disclosure of inform...
Evaluation and Management of Hepatic Injury
Purpose The liver is the most frequently injured abdominal organ. Most injuries are minor and can heal spontaneously without operative management. Unrecognized injury can be a cause of preventable death following trauma. The following guidelines outline the a...