305 APPENDIX E ■ ATLS and Trauma Team Resource Management
box e-1 checklist for the trauma team leader
• Introduce the team and assign roles.
• Identify the scribe.
• Explain how the team will communicate and use
time-outs.
• Ensure that all team members adhere to universal precautions.
• Ensure assistants are available to help team members.
• Prioritize patient management during the primary survey.
• Order appropriate diagnostic interventions and clinical
procedures, and ensure that they are carried out rapidly
and accurately.
box e-2 team leader briefing the trauma team
• Introduce yourself, and ensure all team members know
you are the team leader.
• Ask team members to introduce themselves to you and
other members as they arrive.
• Establish the skill levels of team members, especially
their competency to perform practical procedures, and
assign roles appropriately. Establish that nurse assistants
are familiar with the environment, particularly the
location of equipment.
• Allocate the role of scribe to a suitable member of the
team and ensure that documentation is timely.
• Ensure that team members use universal precautions to
appropriately protect themselves from infectious hazards.
• Explain the procedure for taking handover of the patient.
• Ensure that team members know how to communicate
important positive and negative findings during the
primary survey, especially when the patient’s
condition deteriorates.
information to the team taking over without delay or
prolonged discussion.
The MIST mnemonic is an excellent handover tool
that can be used in a time-pressured environment to
ensure safe transfer of information without loss of
important details:
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• Check results of investigations once performed (e.g.,
review CT scan report).
• Make sure relatives are aware of what is happening.
• Call additional specialist team members when needed.
• Arrange for definitive care and communicate with
receiving physician, when appropriate.
• Check that documentation is inclusive.
• Debrief the team.
• Emphasize that important information about the primary
survey must be communicated directly to you, the
team leader.
• Give clear instructions for any lifesaving procedures
required during the primary survey, and establish the
priority of these procedures.
• Explain that “time-outs” occur at approximately 2, 5, and
10 minutes. These give the opportunity to review the
condition of the patient and plan further resuscitation.
• Emphasize that team members who need additional
support, equipment, drugs, or resources must
communicate directly to you, the team leader.
• Greet any additional providers who arrive to assist
the team, although their help may not be immediately
required. Assign roles and responsibilities when
appropriate. For example, a neurosurgical consultant may
not be required during the primary survey, but may be
necessary when deciding if a patient requires craniotomy
or intracranial pressure monitoring.
• Mechanism
• Injuries sustained
• Signs
• Treatment and travel