Management of Traumatic Scene Incidents

Management of Traumatic Scene Incidents
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Management of Traumatic Scene Incidents
High-risk environments, like scenes of traumatic incidences, require effective communication strategies, coordination, collaboration, cooperation, and understanding to ensure patient safety and effective care and prevent healthcare errors. Problems in shared activities in patient management in a traumatic scene, including communication errors, ineffective leadership, and poor work organization, cause medication errors that hinder patient safety. Nevertheless, the inter-professional care team should consider the laws of physics that govern movements, injury pattern recognition, and mechanism of injury when helping trauma victims. This paper discusses the concepts related to the assessment and management of traumatic incidences, including communication, mechanism of injury, and coordination.
Communication and Collaborative Working Aspects
The inter-professional team in the traumatic incident scene should consider every contribution of team members. Traumatic incidents in the UK, like the Grenfell Tower fire, reflected the need for collaboration, coordination, and effective communication in emergency services when managing such incidents (Davidson et al. 2022). The team members, including the police, fire, and ambulance personnel, should respectfully interact with understanding and good communication since communication failure between them can endanger patient safety (Courtenay, Nancarrow, & Dawson 2013). They should reflect a crucial aspect of clear communication when managing the patient in a traumatic incident and effectively coordinate and cooperate to ensure the patient’s safety. For instance, they should communicate clearly regarding the patient’s injuries, the priority for care in the triage category, and the patient’s vital signs. Effective communication enhances situation awareness regarding the traumatic incident, and closed-loop communication helps share any information, such as abnormal concerns from the traumatic incident (Kostiuk & Burns 2020). Consequently, comprehensive details concerning the traumatic scene and victim enhance effective patient care.
In addition, leadership is a vital aspect needed in collaborative working on the scene of a traumatic incident. Courtenay, Nancarrow, and Dawson (2013) explained that effective leadership enhances good team function in a traumatic scene since the leaders are responsible for directing the team activities when managing the incident. The leader enhances team organization by effectively coordinating the team members’ roles while conveying collaborative decisions about the traumatic incident. For instance, an incident commander can lead the other team members in a traumatic incident. The team leader should make timely contact with the police and fire and ambulance personnel to enhance situation awareness and jointly decide how to resolve the traumatic scene in a timely and coordinated way (National Ambulance Resilience Unit 2015). Additionally, the team leader assigns specific tasks while updating the team members on changes and new findings regarding the traumatic incident (Kostiuk & Burns 2020). Consequently, effective leadership would promote joint work on the scene.
Moreover, the JESIP (Joint Emergency Services Interoperability Program) is necessary at the traumatic scene since it offers principles for effective collaboration and coordination. The program encourages inter-professional team members to communicate clearly without abbreviations or technical jargon when managing traumatic incidences, enhancing collaboration and coordination (Davidson et al. 2022). Additionally, they should co-locate with other responders promptly at an easily pinpointed, safe, and single location. Furthermore, they should cooperatively increase their situation awareness, jointly understand risk through information sharing, and coordinate by acknowledging the lead organization to identify the needed resources, capabilities, and priorities for effective responses (Kerslake, 2018). The team should conduct a risk assessment procedure (METHANE report) and collaborate in location verification to ascertain the significant incident (M), the exact place or location (E), the type of emergency incident (T), the hazards at the location (H), access to the route (A), the number of traumatic victims (N), and the needed emergency services (E) (National Ambulance Resilience Unit 2015). The report helps in understanding the risk, prioritizing activities and victims, and effectively performing the team’s specific roles.
Additionally, it is necessary to have a command and control structure that links with the National Ambulance Resilience Unit in traumatic scenes to enhance coordination of response and effective working. The Bronze, Silver, and Gold commanders retain their rank structure and command of their resources at the scene. At the strategic level, the Gold commanders set the strategic direction of the needed actions by prioritizing scarce resources and coordinating responder agencies. In contrast, the Silver commanders offer solutions by interpreting the strategic direction and coordinating assets and activities at the tactical operations (Kerslake, 2018). Conversely, at the operational level, the Bronze scene commanders co-locate with other team members at an identified location and deliver solutions by holding multiagency briefings to coordinate actions, communicate the tactical plan, and convey the service response (Kerslake, 2018). The command structures help in prioritizing the activities and deploying assets for effective coordination and working at the traumatic scene.
Furthermore, professional collaboration among the police and the fire and ambulance personnel, coordination of activities, and mutual dependence are significant aspects of collaborative working since they enhance risk management, team performance, and work efficiency when working under traumatic incidences (Courtenay, Nancarrow, & Dawson 2013). The National Ambulance Resilience Unit (NARU) in the UK provides the necessary resources, equipment, and guidance for managing traumatic incidences on the Smart Motorway networks. The police lead the resolution of the traumatic incident, set the message signals and signs concerning the traumatic incident, and control and coordinate all vehicle movements around the traumatic scene. Conversely, the ambulance personnel provide first aid, victims’ evacuation, and display warning sirens and lights to warn any person or traffic about the traumatic incident. Contrarily, the fire personnel extinguish the fire and collaborate with the police to ensure scene safety by implementing safety strategies that protect personnel, property, and operations at the traumatic scene (National Ambulance Resilience Unit 2015). Each team member reflects inter-professional boundaries since they only perform roles based on their expertise.
Additionally, Pollock’s report provides guidance on resilience and interoperability for effective inter-professional working. The top management should be committed to setting a resilience philosophy and communicating and creating a resilient culture as a priority in traumatic scene management (Pollock 2013). Furthermore, the team members should have specific organizational responsibilities and be committed to safe operations when involved in traumatic scenes. Moreover, adopting a Triage Sieve tool as a primary incident triage tool in the UK helps collaborate during traumatic scene management. The tool prioritizes the limited healthcare resources to increase survival among trauma victims. Therefore, the team members can coordinate to enhance disaster preparedness and prioritize victims based on the urgency of the needed interventions (Malik et al., 2021). The triage sieve tool facilitates a significant improvement in detecting traumatic patients requiring life-saving and time-critical interventions, enhancing collaborative efforts toward these priorities. Furthermore, the triage sieve tool promotes collaborative working in traumatic scene management by ensuring that limited medical resources achieve maximum benefits for the most significant number of victims and guiding about the onward transfer and the relevant destination for medical care (Malik et al., 2021). Consequently, good coordination and multiagency collaboration in traumatic scene management maximize the victims’ survival.
Nevertheless, several challenges are associated with inter-professional working in a traumatic incident, hindering effective communication, coordination, and collaboration toward patient safety. The severity of the case in a traumatic scene, time constraints, and systematic-level factors, such as inadequate resources like electronic interface equipment, interagency radio links, and staff, negatively impact inter-professional working (Kerslake, 2018; National Ambulance Resilience Unit 2015). The pain associated with traumatic injuries among the victims also challenges communication with personnel. In addition, it can be hard to balance operations when one person has multiple demanding responsibilities (Kerslake, 2018). For instance, a Police Gold Commander can have low effectiveness when concurrently coordinating the response activities and handling the responsibilities of other positions, like the Duty Strategic Firearms Commander. Inadequate confidence and awareness about the procedures, primary roles, and priorities for handling victims in major traumatic incidents also challenge inter-professional working. Furthermore, using jargon and technical language negatively affects communication. Additionally, team dynamics, negative emotions, and varying personalities and hierarchies can hinder proper inter-profession working (Etherington et al. 2021). Addressing the varying challenges can foster collaborative inter-professional working in traumatic incidences.
The inter-professional team can adopt multiple strategies to overcome the challenges associated with inter-professional working. The team leader can delegate roles to different members to avoid giving one officer multiple demanding responsibilities that cause low effectiveness (Kerslake 2018). Kerslake (2018) also recommended establishing clear objectives to enable the strategic coordinating group to perform timely briefings and responses within two hours after a traumatic incident. They should also use simple-to-understand language while avoiding jargon and technical words. Etherington et al. (2021) highlighted that educational campaigns and debriefings can address the personality differences barrier and inadequate awareness of procedures and priorities. Understanding the procedures and roles during the first 30 minutes of a significant incident also boosts confidence when managing the scene (Kerslake 2018). Furthermore, continuous professional development and inter-professional team education strategies can help team members recognize and challenge biases and help manage emotional challenges like fear and low confidence. Moreover, intervention development in health facilities can prevent resource-related barriers to inter-professional working by catering to staff and equipment availability in traumatic scenes (Etherington et al. 2021). Therefore, the different strategies can help to overcome challenges associated with inter-professional working.
Assessing and Managing the Patient
It is necessary to use a systematic approach to assess and manage the victims in the traumatic incident to enhance effective care and well-being. The ABCDE approach is a primary survey that considers the patient’s airway, breathing, blood circulation, possible disabilities, and exposure to help in assessing, treating, and managing the injured patient since it improves the quality and speed of treatment (Nicodemo et al. 2008; Thim et al. 2013). Furthermore, the technique is life-saving and helps to break down the complex traumatic incident into more management components. It also enhances situational awareness among the inter-professional team members and provides ample time for establishing a final diagnosis and treatme...