Recently, in my intermediate diagnostic imaging lectures we have been given two presentations looking at different aspects of trauma within radiography, the role of a radiographer and the radiographer as part of a multidisciplinary trauma team. This along with the fact that trauma radiography interests me and my fascination with the patient pathway of a trauma patient has provoked me to research further into ‘trauma teams’ and the dynamics of a radiographer.
At my previous placement in the Bristol Royal Infirmary I got to witness and participate within a trauma team, I found it exciting but also rather daunting at the same time, as the patient was very unwell and needed immediate care, there were a lot of people with different roles also participating within the patients immediate care needs. It was very interesting to see how all of these separate individuals worked together.
Trauma radiography can be challenging and exciting for a radiographer, however obtaining images of good diagnostic quality can also be extremely stressful. If a radiographer is well prepared, able to maintain composure and also be willing to interact within a multidisciplinary team then this can slightly ease the pressure of the situation.
Trauma is defined as ‘a serious injury or shock to the body, from violence or caused by an accident’. (Farlex. Inc, 2014). Trauma is the fourth leading cause of death in the UK in individuals within their first forty years of life (Sailsbury NHS Foundation Trust, 2013), This is why when dealing with a trauma patient timing is very important, as this could result in the loss of a patient’s life, to minimise the amount of time a radiographer spends acquiring images from a trauma patient, Emergency Departments usually have designated diagnostic equipment located either in the department or extremely close. The first hour after trauma has occurred is called the ‘golden hour’ (Newgard, 2010), and begins the moment the trauma occurs, it is crucial that the patient receives the best possible care within this hour as it can increase the patients chance of survival. The patient while still at the scene of the trauma may encounter paramedics who will transport the patient to hospital where the trauma team will have already assembled and be prepared to deal with any situation that the patient presents.
Once the patient has arrived within the Emergency Department, he/she will encounter a multitude of health professionals; all of these individuals work together and become the ‘Trauma’ team. The trauma team is a multidisciplinary team, within which multiple health professionals work together to promote the best outcome for the patient and to provide the best standard of care. This team consists of:
- Team Leader
- Anaesthetist assistant
- General Surgeon
- Orthopaedic Surgeon
- Emergency Room Physician
These individuals make up the core of the team, but there may be other members of staff present such as:
Outside of the immediate trauma team there may also be other health professionals who are indirectly involved within the patients care, such as radiologists, who will authorise additional radiographic procedures that the trauma team leader may require the patient to undergo, theatre staff may also be prepared and waiting if it is thought that the patient may require immediate surgery. Every individual that participates directly or indirectly within the patients’ immediate care needs are all working together as a multidisciplinary team towards the best outcome for the patient, and to provide ‘patient centred care’ which is the main role of the National Health Service (NHS). (Bates & Grimes, 2014).
The role of the radiographer within this team is to start a trauma series of x-rays, firstly starting with a lateral c-spine, then a chest and pelvis x-ray. These views should be obtained in all trauma patients within a trauma situation unless otherwise told by the team leader. (Trauma.org, 2014). It can be hard for the radiographer to safely obtain these images and comply with radiation protection legislations as there may be a lot of individuals within a small immediate area. Radiation Protection is one of the most important duties of the radiographer within a trauma environment; it is the responsibility of the radiographer to protect the patient, trauma team members and them self. In some high risk trauma situations it is impossible for certain members of the trauma team to leave the patient for an x-ray to be obtained, in this instance the radiographer must ensure that team members are wearing lead aprons and that all other team members have moved away to a safe location. (The Royal College of Radiologists and The Society and College of Radiographers, 2012)
The role of a radiographer is described by the Society of radiographers (2003) as being responsible for providing safe and accurate imaging examinations in a wide range of clinical environments, whilst using a variety of imaging modalities and techniques so that appropriate management and treatment of patients can proceed. I believe that within a trauma situation the role of the radiographer can evolve, it was evident in my experience of a trauma team that not only did the radiographer acquire the image but also had to undertake tasks that may be classed as ‘outside’ a radiographer’s role. Some hospitals specify that a radiographer must answer a trauma call within 5 minutes (The Royal Childrens Hospital, 2012) as the first hour after trauma is referred to as the ‘golden hour’ (Newgard, 2010) and timing is critical. The Radiographer must not leave until they have been dismissed. It is also very important that the radiographer lets the existing team know that they have arrived and also when the images are available to view. There may also be other radiographers involved within this patient’s pathway, for example, if the patient is required to have a CT scan; it is the radiographer’s job to perform this scan.
In conclusion it can be seen that radiography is fundamental within trauma patients’ as it is one of the main diagnostic tools available, and information that may impact on the outcome of a trauma patients care and/or weather anything can be done to help the survive their trauma is gained from radiographic procedures quickly and accurately.
Bates, S. & Grimes, K., 2014. Quality Report Kingston NHS, London: s.n.
Farlex. Inc, 2014. The Free Dictionary. [Online] Available at: http://www.thefreedictionary.com/trauma [Accessed 15 October 2014].
Newgard, C., 2010. Emergency Medical Service Intervals and Survival in Trauma: Assesment of the ‘Golden Hour’. Emergency Medicine, 55(4), pp. 235-246.
Sailsbury NHS Foundation Trust, 2013. Sailsbury NHS Foundation Trust. [Online] Available at: http://www.icid.salisbury.nhs.uk/ClinicalManagement/OrthopaedicsAndTrauma/Pages/TraumaTeam.aspx [Accessed 16 October 2014].
The Royal Childrens Hospital, 2012. Trauma Team Compisition Roles. [Online] Available at: http://www.rch.org.au/paed_trauma/guidelines/Trauma_team_composition_roles/#Radiographer [Accessed 16 October 2014].
The Royal College of Radiologists and The Society and College of Radiographers, 2012. Team Working in Clinical Imaging, London: The Royal College of Radiologists and The Society and College of Radiographers.
Trauma.org, 2014. Trauma.org. [Online] Available at: http://www.trauma.org/archive/resus/traumateam.html [Accessed 15 October 2014].