Trauma

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ME 3.20.1.1

Mechanisms of injury.

ME 3.20.1.2(a)

Principles of trauma management, including: Classification and description of fractures, dislocations, sprains and strains

ME 3.20.1.2(b)

Principles of trauma management, including: Fracture, wound and burn healing

ME 3.20.1.2(c)

Principles of trauma management, including: Pathophysiology of hypovolaemic shock

ME 3.20.1.3(a)

Epidemiology of trauma, including: Trimodal peak of mortality

ME 3.20.1.3(b)

Epidemiology of trauma, including: Relationships between injury mechanisms, patterns and prognosis, particularly blunt and penetrating trauma

ME 3.20.1.4

Identify the trauma patient who requires initiation of resuscitation.

ME 3.20.1.5

Complete a primary trauma survey in an injured non-complex adult patient, incorporating point of care testing as required, and identify life-threatening abnormalities requiring emergent intervention.

ME 3.20.1.6

Complete a culturally safe secondary trauma survey who no longer requires ongoing resuscitation or critical care interventions.

ME 3.20.1.7

Perform a comprehensive culturally safe limb examination, including neurological, vascular and joint assessment.

ME 3.20.1.8

Apply concepts of healing by primary and secondary intention to the creation of treatment plans for non-complex open wounds.

ME 3.20.1.9(a)

Identify and manage the following in trauma patients: Scalp and other laceration

ME 3.20.1.9(b)

Identify and manage the following in trauma patients: Removal of superficial and subcutaneous foreign bodies

ME 3.20.1.9(c)

Identify and manage the following in trauma patients: Minor head injury, including post-concussive syndrome

ME 3.20.1.9(d)

Identify and manage the following in trauma patients: Sprains and strains of joints

ME 3.20.1.9(e)

Identify and manage the following in trauma patients: Burns not requiring immediate transfer to a Burns Unit

ME 3.20.1.10(a)

Perform relevant simple initial treatment procedures, including: Spinal protection and clearance

ME 3.20.1.10(b)

Perform relevant simple initial treatment procedures, including: Pelvic binding/splinting

ME 3.20.1.10(c)

Perform relevant simple initial treatment procedures, including: Intravenous or intraosseous access

ME 3.20.1.10(d)

Perform relevant simple initial treatment procedures, including: Supportive management of orthopaedic injuries

ME 3.20.1.10(e)

Perform relevant simple initial treatment procedures, including: Basic skin suturing techniques and alternate skin closure, including tissue adhesives and staples

ME 3.20.1.11

Prescribe appropriate analgesia for a patient, including the use of physical therapy.

ME 3.20.1.12

Create a discharge and follow-up plan for a patient from the ED, incorporating likely health progression from injury.

ME 3.20.2.1(a)

Principles of trauma, including: Trauma resuscitation

ME 3.20.2.1(b)

Principles of trauma, including: Trauma coagulopathy

ME 3.20.2.2(a)

Trauma systems, including: Prehospital transport, communication and handover

ME 3.20.2.2(b)

Trauma systems, including: Trauma centre designation and trauma triage

ME 3.20.2.2(c)

Trauma systems, including: Interhospital transport

ME 3.20.2.2(d)

Trauma systems, including: Trauma registry

ME 3.20.2.3(a)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Paediatric patients

ME 3.20.2.3(b)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Geriatric patients

ME 3.20.2.3(c)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Patients on multiple medications

ME 3.20.2.3(d)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Obstetric patients

ME 3.20.2.3(e)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Bariatric patients

ME 3.20.2.3(f)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Vulnerable patients following assault

ME 3.20.2.3(g)

Trauma scoring systems, epidemiology, incidence, and patterns of injury, including the following populations: Patients with penetrating versus blunt trauma

ME 3.20.2.4

Pathophysiology of clinical signs and symptoms due to breathing, circulatory, and neurological injury.

ME 3.20.2.5(a)

Principles of assessment of the trauma patient, including: Trauma triage

ME 3.20.2.5(b)

Principles of assessment of the trauma patient, including: Primary, secondary and tertiary survey

ME 3.20.2.5(c)

Principles of assessment of the trauma patient, including: Severity of hypovolaemic shock

ME 3.20.2.5(d)

Principles of assessment of the trauma patient, including: Systematic assessment of life threats

ME 3.20.2.5(e)

Principles of assessment of the trauma patient, including: Systematic assessment of multitrauma

ME 3.20.2.5(f)

Principles of assessment of the trauma patient, including: Roles and pitfalls of vital signs, such as heart rate, blood pressure, saturations, respiratory rates, non-invasive and core temperature, Glasgow Coma Scale, blood sugar, pupillary reflexes, neurovascular status of distal limbs

ME 3.20.2.5(g)

Principles of assessment of the trauma patient, including: Point of care testing, such as x-ray, bedside ultrasound, blood gas, urinalysis, blood sugar

ME 3.20.2.5(h)

Principles of assessment of the trauma patient, including: Rational investigation choice, including radiology, other medical imaging, lab tests including thromboelastometry

ME 3.20.2.5(i)

Principles of assessment of the trauma patient, including: Culturally and psychologically safe and supported inclusion of family/whānau

ME 3.20.2.6(a)

Principles of trauma management, including: Multidisciplinary approach

ME 3.20.2.6(b)

Principles of trauma management, including: Early management of severe trauma

ME 3.20.2.6(c)

Principles of trauma management, including: Advanced trauma life support

ME 3.20.2.6(d)

Principles of trauma management, including: Damage control resuscitation

ME 3.20.2.6(e)

Principles of trauma management, including: Indications for conservative versus operative management

ME 3.20.2.6(f)

Principles of trauma management, including: IV fluid choices and uses in trauma

ME 3.20.2.6(g)

Principles of trauma management, including: Blood transfusion and component therapy, including massive transfusion, and cultural and religious differences surrounding receipt of blood products

ME 3.20.2.6(h)

Principles of trauma management, including: Indications and preparation for intra- and inter-hospital transfer of the trauma patient

ME 3.20.2.6(i)

Principles of trauma management, including: Trauma patient rehabilitation, including the risk of secondary psychiatric injury

ME 3.20.2.7(a)

Classification, description and principles of management of trauma presentations, including: Head trauma

ME 3.20.2.7(b)

Classification, description and principles of management of trauma presentations, including: Maxillofacial trauma

ME 3.20.2.7(c)

Classification, description and principles of management of trauma presentations, including: Neck injuries

ME 3.20.2.7(d)

Classification, description and principles of management of trauma presentations, including: Vertebral column and spinal cord injuries

ME 3.20.2.7(e)

Classification, description and principles of management of trauma presentations, including: Chest trauma

ME 3.20.2.7(f)

Classification, description and principles of management of trauma presentations, including: Abdominal trauma

ME 3.20.2.7(g)

Classification, description and principles of management of trauma presentations, including: Major pelvic injury

ME 3.20.2.7(h)

Classification, description and principles of management of trauma presentations, including: Genitourinary trauma

ME 3.20.2.7(i)

Classification, description and principles of management of trauma presentations, including: Extremity trauma, including traumatic amputation, arterial injury, compartment syndromes and crush syndrome

ME 3.20.2.7(j)

Classification, description and principles of management of trauma presentations, including: Hypothermia and hyperthermia

ME 3.20.2.7(k)

Classification, description and principles of management of trauma presentations, including: Burns requiring admission, including:

ME 3.20.2.7i)

Classification, description and principles of management of trauma presentations, including: Inhalation injury

ME 3.20.2.7ii)

Classification, description and principles of management of trauma presentations, including: Chemical burns

ME 3.20.2.7iii)

Classification, description and principles of management of trauma presentations, including: Electrical burns

ME 3.20.2.7iv)

Classification, description and principles of management of trauma presentations, including: Tar burns

ME 3.20.2.7v)

Classification, description and principles of management of trauma presentations, including: Sunburn

ME 3.20.2.7vi)

Classification, description and principles of management of trauma presentations, including: Oral burns

ME 3.20.2.8

Principles of fluid resuscitation in trauma.

ME 3.20.2.9

Principles of blood product resuscitation in trauma, including massive transfusion protocols.

ME 3.20.2.10
ME 3.20.2.11(a)

Perform the following procedures: Wound exploration, cleaning, irrigation and debridement,

ME 3.20.2.11(b)

Perform the following procedures: Incision and drainage of simple, superficial abscesses

ME 3.20.2.11(c)

Perform the following procedures: Apply superficial wound dressings

ME 3.20.2.11(d)

Perform the following procedures: Pack open wounds

ME 3.20.2.11(e)

Perform the following procedures: Drainage of subungual haematomas

ME 3.20.2.12

Contribute to providing first line resuscitative treatment to a trauma patient, including a patient in cardiac or respiratory arrest.

ME 3.20.2.13

Perform procedures that provide ongoing stability of the patient post-resuscitation and prior to admission.

ME 3.20.2.14

Create a safe disposition plan for a trauma patient requiring admission.

ME 3.20.2.15

Justify prioritisation of multiple tasks in a single trauma patient.

ME 3.20.2.16

Justify prioritisation of multiple injuries based on injury severity, likelihood of consequences to patient, facilities available in the ED.

ME 3.20.3.1(a)

The importance of public health advocacy in relation to trauma, including: Role of public education, trauma prevention programs, and legislation as pertains to trauma occurrence

ME 3.20.3.1(b)

The importance of public health advocacy in relation to trauma, including: Local trauma epidemiology, including patterns of domestic violence and child abuse

ME 3.20.3.2

Trauma scoring systems.

ME 3.20.3.3(a)

Pathophysiology of sequelae from inadequately treated or unidentified injuries and their complications. Principles underpinning trauma teams, including: Structure and role of trauma teams in the reception and management of severe trauma

ME 3.20.3.3(b)

Pathophysiology of sequelae from inadequately treated or unidentified injuries and their complications. Principles underpinning trauma teams, including: Principles of Crisis Resource Management

ME 3.20.3.3(c)

Pathophysiology of sequelae from inadequately treated or unidentified injuries and their complications. Principles underpinning trauma teams, including: Contributions of other medical disciplines in trauma management, such as pre-hospital and retrieval medicine, anaesthesia, surgery, intensive care medicine, radiology

ME 3.20.3.4

Trauma team training.

ME 3.20.3.5

Leadership in the management of trauma patients with varied severity in the hospital environment/network.

ME 3.20.3.6

Pathophysiology of life-threatening injuries and their relationship to mechanism of injury.

ME 3.20.3.7

Principles of common lifesaving procedures in the critically injured patient.

ME 3.20.3.8

Pathophysiology of multisystem trauma.

ME 3.20.3.9

Physiological effects of medications and fluids used in resuscitation of multitrauma patients.

ME 3.20.3.10

Beyond the Resuscitation Room management of the severely injured trauma patient, including prioritising the order of interventional radiology, timing to operating theatre versus time to CT.

ME 3.20.3.11

Complications of resuscitation in the trauma patient.

ME 3.20.3.12

Production of false vital signs based on co-morbidities and patient's ongoing medication use.

ME 3.20.3.13(a)

Adaptations to principles of management of trauma in special cases, including the following: Paediatric population, including non-accidental injury

ME 3.20.3.13(b)

Adaptations to principles of management of trauma in special cases, including the following: Obstetric population, including obstetric complications of trauma and uterine rupture'

ME 3.20.3.13(c)

Adaptations to principles of management of trauma in special cases, including the following: Elderly trauma population

ME 3.20.3.13(d)

Adaptations to principles of management of trauma in special cases, including the following: Bariatric patients

ME 3.20.3.13(e)

Adaptations to principles of management of trauma in special cases, including the following: Multiple casualties/disaster

ME 3.20.3.13(f)

Adaptations to principles of management of trauma in special cases, including the following: Patient(s) on multiple medications

ME 3.20.3.13(g)

Adaptations to principles of management of trauma in special cases, including the following: Vulnerable patient(s) post-assault

ME 3.20.3.14

Role of the Coroner in trauma patients.

ME 3.20.3.15

Principles of balanced blood product resuscitation, including viscoelastic haemostatic testing guidance.

ME 3.20.3.16

Resuscitate a critically injured patient with an expanded range of therapies beyond first line treatments, including haemostatic resuscitation.

ME 3.20.3.17(a)

Assess and resuscitate a high-complexity patient due to comorbid conditions, including: Coagulopathy

ME 3.20.3.17(b)

Assess and resuscitate a high-complexity patient due to comorbid conditions, including: Cardiorespiratory illness

ME 3.20.3.17(c)

Assess and resuscitate a high-complexity patient due to comorbid conditions, including: Reduced physiological reserve, such as in patients with renal conditions, diabetes and elderly and paediatric patients

ME 3.20.3.18

Diagnose multiple injuries.

ME 3.20.3.19(a)

Provide specialised emergency treatment to the following injuries: Eye, ear, and maxillofacial injuries, including reduction of temporo-mandibular joint

ME 3.20.3.19(b)

Provide specialised emergency treatment to the following injuries: Dental injuries, including stabilising an injured tooth and bleeding following dental extraction

ME 3.20.3.19(c)

Provide specialised emergency treatment to the following injuries: Severe burns requiring transfer to Burns Unit

ME 3.20.3.19(d)

Provide specialised emergency treatment to the following injuries: Penetrating wounds, including those into joints, thoracic cavity, and abdominal cavity

ME 3.20.3.19(e)

Provide specialised emergency treatment to the following injuries: Solid intra-abdominal and intrathoracic organ injury

ME 3.20.3.19(f)

Provide specialised emergency treatment to the following injuries: Moderate and severe head injury,

ME 3.20.3.19(g)

Provide specialised emergency treatment to the following injuries: Traumatic limb injury necessitating amputation

ME 3.20.3.20

Initiate treatment to prevent short term complications of injuries, including raising intracranial pressure and compartment syndromes.

ME 3.20.3.21

Perform tertiary trauma survey assessment for patients in the Short Stay Unit of the ED.

ME 3.20.3.22

Co-ordinate the discharge of the trauma patient.

ME 3.20.4.1

Create a resuscitation and treatment plan for a multitrauma patient in an austere environment.