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)