Direct to Operating Room
VBMC TRAUMA CARE SERVICES GUIDELINE
Direct to OR
Purpose: Avoid the impact of time lost in the Trauma Room (however limited) when operative intervention must be performed immediately to prevent loss of life. To minimize delays to the operating room and initiate lifesaving surgical interventions.
Goal: Consider entirely bypassing the ED and transporting the patient directly to an OR that is prepared. DOR resuscitation can be suggested by prehospital personnel based upon field assessment or by the ED charge nurse based upon the report. Direct to OR activation can be made only by the Trauma Attending.
Possible Indication for Direct OR Admission:
1. Thoracic
injury with open cavity
2. Evisceration
of abdominal contents
3. Penetrating
injuries or impalement of the neck, chest, abdomen, or pelvis with SBP < 90
4. Profound
shock (adults: SBP <80) with CT or ultrasound evidence of
hemoperitoneum
5. Massive
blood loss on scene or en route with ongoing uncontrollable external loss
(excluding GSW to head)