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Mohd Najmi Abd Salam

Abstract

DEALING WITH MULTIPLE UNSTABLE PENETRATING ABDOMINAL TRAUMA CASES- ROLE OF TRAUMA TEAM AND CODE BLACK ACTIVATION


 


Mohd Najmi Abd Salam1, Ranjini Sivaganabalan2, Norafizan Mohd Ali3 Zuriyah Ariffin4


 


1 Hospital Tengku Ampuan Rahimah, Klang, Malaysia


 






Introduction


Trauma team was introduced in Hospital Tengku Ampuan Rahimah (HTAR), Klang since 2012. It comprised of 3 departments (ED, Surgery and Radiology). Once activated, surgeon and medical officer of surgery department will come immediately to manage the patient together with ED team. Radiographer will bring portable x-ray machine to the resuscitation area. Apart from that ED HTAR also has introduced code black activation. Once code black activated additional staff will mobilize to resuscitation area including doctors, assistant medical officer, staff nurse. There are criteria for trauma and code black activation.


 


Case report


Recently we had encountered 4 cases of unstable penetrating abdominal trauma that came in simultaneously. 2 of the cases were bowel evisceration. Trauma team was activated as they developed hypotension on arrival to ED. At the same time, code black activated as there were 4 cases that required simultaneous active resuscitation. Additional ED staffs from other zones were mobilized to resuscitation area to aid in the patients care. The treatment went smoothly as it involved additional staff from ED and surgical department. Patients were rushed to operating theatre immediately within 1 hour, shorter than the mean time from trauma team HTAR data that is 129 minutes. 3 emergency operation theaters were open simultaneously that day.


 


Discussion and conclusion


Trauma team and code black activation can shorten the time for surgical intervention. The cornerstone of this activation is early involvement of emergency physician, surgeon and mobilization of additional staff to resuscitation area. In conclusion, the introduction of trauma team & code black are essential in managing multiple trauma cases in emergency department HTAR.


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 





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Section
EMAS Meeting 2019 Abtracts