The idea of having checklists for trauma comes from these two episodes form EMCrit with guest Dr Hicks (TTL in Toronto).

EMCrit 278 – Labors of Trauma – Blunt Edition (Part 1)

EMCrit 282 – Hicks on the Labors of Trauma (Blunt)

The second episode is really the one that caught my attention. Particularly the checklists before the patient arrives or leaves the department after major trauma.

So, I have decided to create one for myself. At the Landspítali, we might not be the busiest trauma center in the world, but we are still the biggest and only trauma center on the island.

WE ARE IT.

So better get our sh*t together.

Evidence

Regarding checklists use in trauma, it is not like there is tons of evidence.

One meta-analysis showed that the use of checklist in trauma improved the flow of patients, reduced time to certain interventions and decreased mortality for the a sub-group of the sickest patients.

In pediatric trauma, using a checklist decreased significantly time for certain tasks (cervical spine immobilization, oxygen, palpating pulses) and vitals signs were obtained faster.

These checklists focused on trauma management, not on how to prepare before the patient arrives or leaves the department.

Still, the absence of evidence does not mean there is no evidence to do it. A well-prepared team that make sure critical steps or interventions are not forgotten, likely has better outcomes than one that is not…

WHO Trauma checklist

WHO has been pushing for a Trauma Care Checklist to be implemented for low- to high-income countries. Their checklist has been more of a cookie-cutter and felt like we needed to adapted it to our center.

This is the WHO Trauma Checklist. It is ready to print and you could just put it on your trauma bay wall tomorrow. It is a great start.

Same but different is what Dr Hicks posted :

Own/Landspítali Pre-Arrival and Pre-Departure Trauma Checklists

After digesting the WHO’s and Dr Hick’s list, here are my checklists :

At the end, we put what we want on it and the focus is mostly on things that are either evidence-based (i.e. TXA) or something we tend to overlook (i.e. chart neurovascular examination on all 4 limbs)

It is easy and cheap to print and I highly encourage our staffs and residents to print it and put it under their badges.

Looking forward for feed-back or ways to improve it!

Instructions

1. Download the document below (trauma-checklist-final)
2. Print and plastify (Went to Pixel to print it 10cm wide and 14cm long, both sides and covered with plastic)
3. Print it and make a pin at the bottom
4. Carry it under your hospital badge upside down so when I want to read it, I just pull on it and read
5. A trauma comes in, you check your Trauma Pre-arrival checklist to make sure you are well prepared
6. Once the patient is leaving to the OR, radiology or ICU, just flip your card and make sure you have not forgotten anything with the Trauma Pre-departure checklist