Trauma management

1. Introduction

All general practitioners training with the RACGP are required to meet the requirements outlined in the RACGP Curriculum for the management of trauma: 

CS2.2.3.1b: Establish a diagnosis and manage clinical presentations of acute serious illness and trauma efficiently and appropriately. 

These skills must be maintained during training.

2. Definitions

ARC means Australian Resuscitation Council

Trauma includes, but is not limited to:

  1. Head trauma – concussion assessment and management;
  2. Neck and spinal trauma;
  3. Ocular trauma, including penetrating injury and hyphaema;
  4. Dental trauma, including management of avulsed teeth;
  5. Abdominal trauma, including visceral rupture;
  6. Chest trauma, including traumatic pneumothorax;
  7. Electrocution, drowning, burns;
  8. Sexual assault/rape, intimate partner violence, child abuse and family violence;
  9. Fractures and dislocation, including identification of associated nerve, vascular or tendon injuries; 

Trauma management includes, but is not limited to:

  1. Emergency management of haemorrhage, burns, head injury, suspected spinal injury, crush injury and fractures. 

3. Guidance

3.1 The range of emergency presentations that may occur in general practice is broad and the skills required in management are directly related to the context of the general practice setting.

3.2 General practitioners in rural and remote areas require a higher level of emergency care skills due to lower numbers of GPs, reduced access to specialist services, and the logistic and geographic difficulties of evacuating seriously ill patients. There is also a higher incidence of farming, mining, industrial and motor vehicle accidents, as well as greater access to firearms in isolated areas.

3.3 As with serious acute illness, patients with major trauma are less likely to present to general practice. They may go straight to an emergency department, although these may be staffed by GPs, especially in smaller or more remote rural hospitals.

3.4 Trauma due to injury may vary in severity of presentation. Minor trauma such as musculoskeletal injuries and lacerations can be managed in general practice.

3.5 GPs should maintain confidence in their level of emergency management skills and be cognisant of the need to access assistance when required.

3.6 Appropriate management of emergency presentations includes utilising evidence-based guidelines – for example, the Australia Resuscitation Council (ARC) First Aid Guidelines – Trauma.

4. References

RACGP Curriculum

RACGP Standards for General Practice Training