ANZAC Day commemorates all Australians and New Zealanders “who served and died in all wars, conflicts, and peacekeeping operations” and “the contribution and suffering of all those who have served”.
Although I personally find it difficult to celebrate the outcomes of war, acts of aggression are a part of our lives and we, as Emergency Physicians, need to be prepared to treat individual victims as well as prepare our departments in case of a disaster. Additionally, many of you have been, or will be, invovled in working in conflict areas. Please take a moment during the public holiday to reflect on the victims as well as the strength and courage of the many who protect the innocent, strive to create peace and treat the victims of aggression.
We have added some relevant educational links:
Major burns are often transferred to the tertiary centres in Melbourne.
The issues to consider include:
- Fluid Resuscitation – caution in fluid overload, reassessment and special patients at risk of pulmonary oedema
- Airway management – early intubation in inhalation injuries associated with respiratory distress, elderly or COPD with minimal respiratory reserve or those requiring transfer to a tertiary centre
ANALGESIA IN TRAUMA
It is easy to forget to provide adequate and appropriate pain releif while focussing on the resuscitation of the patient and the management of severe injuries.
The key issues:
- Adequate analgesia promotes healing, reduces post-traumatic stress response, improves morbidity and mortality and reduces length of stay
- Appropriate assessment tool depending on age, cultural background and language
- Reassessment of pain score
- Use of multimodal analgesia and consider early PCA and nerve blocks
Pain Management in Trauma A review Study_Injury and Violence 2016
Often asked in OSCEs, preparing for a disaster or mass casualty event is not just a hypothetical.
- Details of the event and special situations/injuries – ie: burns, exposure to cold, chemical injuries
- Prepare your team, your department and your hospital
- Post-disaster debreif and hospital recovery
Treating the Enemy – the ethics of warTreating the Doctor