3 ways to train for trauma cases

"Every encounter an ED nurse has with a trauma patient and family makes a definite impression on their lives," says Carrie L. Baumann, RN, BSN, patient care supervisor in the Emergency Department Trauma Center at Children's Hospital of Wisconsin in Milwaukee. Here are three ways to be sure you are prepared for the next trauma case that walks through your door:

  • Give annual updates on new equipment.

"Stay current with the equipment and contents of carts that you have in your department," says Baumann. She offers hands-on teaching when a new piece of equipment comes in, such as pelvic binders, a new blood warmer, or a carbon dioxide monitor. ED nurses also attend a mandatory yearly review on all equipment, including arterial lines and the trauma cart.

At Cincinnati Children's Hospital, all ED nurses and paramedics are provided semiannual training sessions on trauma bay equipment, including the rapid large volume fluid infusers, leather restraints, and defibrillator.

Additional inservices periodically are provided by the ED's core trauma team nurses, says Gordon Lee Gillespie, RN, PhD, a clinical nurse in the ED. Recent inservices have covered medication safety practices in the trauma bay and introducer CORRECT catheter equipment and procedures.

  • Obtain certification.

At Children's Hospital of Wisconsin, all newly hired ED nurses are required to take the Emergency Nursing Pediatric Course (ENPC) or Trauma Nurse Core Curriculum within a year, and all ED nurses are certified in Pediatric Advanced Life Support (PALS).

Baumann says, "I believe that PALS is critical for all those in an emergency room setting. Pediatric dosing of medications is markedly different than that of adults."

Gillespie says, "It is critical for ED nurses in community hospitals to take PALS or ENPC. Both courses provide content on ill or injured children as well as children with special health care needs."

The advantage of taking ENPC in addition to PALS is that ENPC provides content more specific to the ED nurse, such as triage, trauma care, maltreatment, and techniques to better interact with patients and their parents, adds Gillespie.

  • Shadow trauma cases.

Children's ED nurses are required to shadow two trauma cases before they are placed in a role independently. "They will record alongside another nurse or assist the bedside nurse to help gets some hands on in the role," says Baumann.

Nurses do side-by side charting during an actual trauma case, then compare their documentation with the recorder to see what was missed. "It would be beneficial for anyone in the ED to observe a pediatric trauma before they have to jump into one themselves," says Baumann.

At Cincinnati Children's Hospital, a core trauma team nurse now "shadows" behind all new ED nurses until they report being comfortable practicing independently in the trauma bay. When a trauma activation occurs, a second core trauma team nurse also responds and stand behind the new ED nurse providing verbal coaching and mentoring.

Gillespie says, "The goal is for the new ED nurse to act as independently as possible."