This guideline applies to injured patients of all ages.

We recommend that major trauma services retain the capability to perform:

  1. Acute trauma resuscitation and resuscitative procedures.
  2. Emergency surgery to preserve life and limb.

We reiterate that there is risk of COVID-19 transmission from:

  1. Patient to health care worker (HCW).
  2. HCW to patient.
  3. HCW to HCW. 

We recommend that in any setting, clinicians providing trauma care:

  1. Consider a patient at high risk for COVID-19 transmission when:
    • Patient history or clinical assessment is not reliable or unavailable.
    • Clinicians are preparing to deliver trauma care that may include aerosol generating procedures (AGPs), for example pre-hospital or hospital trauma teams receiving trauma patients requiring resuscitation.
  2. Only consider a patient low risk for COVID-19 transmission when:
    • Patient history and clinical assessment has excluded local case definitions.
    • No AGPs are required.
  3. Use senior expertise to limit the number of healthcare workers (HCW) required for safe delivery of trauma care at all stages of the trauma patient journey. This includes and is not limited to:
    • Prehospital and inter-hospital trauma care.
    • Trauma team activations.
    • Transfers to CT, theatre and inter-departmental.

Although the COVID-19 pandemic is likely to reduce traumatic injury presentations overall, there may be a potential skew towards domestic and family violence and self-inflicted injury (Fojut R, ‘How How coronavirus is affecting trauma systems in Italy’. Trauma System News, 21 March 2020. [Link]).

We recommend that:

  1. Non-accidental injury (NAI), domestic violence, elder abuse and self-inflicted injury are considered in all presentations.
  2. Emergency clinicians use a domestic violence screening tool (ACEM, P39 Policy on Family and Domestic Violence. [Link]).

We acknowledge and align with:

  1. The London Major Trauma System: Management of Critical Resources during COVID-19 Pandemic, Clinical Guide for the management of major trauma patients. [Link]
  2. The American College of Surgeons Committee on Trauma ‘Maintaining Trauma Centre Access and Care during the COVID-19 Pandemic’. [Link]
  3. The NHS Clinical guide for the management of trauma and orthopaedic patients during the coronavirus pandemic. [Link]
  4. Australian Orthopaedic Association Position Statement: Orthopaedic surgery during the COVID-19 pandemic. [Link]
  5. Royal Australasian College of Surgeons Statement: Maintaining front-line trauma services during the COVID-19 response. [Link]
  6. Australian Orthopaedic Trauma Society: Guidelines for emergency orthopaedic surgery during the COVID-19 pandemic. [Link]
  7. The NHS Clinical guide for the management of neurotrauma patients during the coronavirus pandemic. [Link]

Exemplar documents:

  1. Royal Adelaide Hospital: Trauma callouts during COVID era. [Link]
  2. Gold Coast University Hospital: ED COVID Trauma/Resus Teams Guide. [Link]
  • Early senior consideration of complexity in COVID-19 trauma care
  • Trauma procedures
  • Trauma systems
  • Prehospital care
  • Location of trauma care
  • Receiving trauma patients in the ED
  • Family in the trauma room
  • Minor trauma
  • Resources
  • References
  • Section disclaimer