Trauma Nursing Fundamentals

How the programme is structured and assessed, and the line this course holds that most trauma teaching does not: the nurse's numbers are in, and the prescriber's numbers are out. Everything you monitor, recognise, report and escalate is stated exactly, with the clause it came from. No medicine dose, rate, regimen or weight-based calculation appears anywhere in the programme - because a dose you half-remember from a course competes with the prescription in front of you.

Also here: the four things this course is NOT. It is not EMST, ATLS, ITLS or TNCC. It is not Trauma-Informed Care, which is a different OBA course about psychological trauma and shares a word with this one and nothing else. It does not place anybody in a trauma team. And it is not your service's protocols - which is why the module ends with ten questions only your own service can answer.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Australian trauma care is a system rather than a set of hospitals. Most services are not major trauma services, and that is the design. So the question at your service is never 'can we manage everything' - it is 'can we recognise what we cannot manage here, and move it fast'.

Designation, destination and bypass criteria are set by each state and territory, so this course states none of them. What it does carry: the RACS Trauma Verification Program, the Australian Trauma Registry - whose every field originated in a clinical record - and the difference between primary transfer, secondary transfer and the one that is actually a failure, which is DELAYED recognition that a transfer is needed. Plus what the golden hour is and is not.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Injury is energy transferred to tissue, and the amount rises with the SQUARE of velocity. Mechanism raises your index of suspicion. It never diagnoses, and it never excludes. Both halves of that get broken, and the second is the dangerous one - a fall from standing height in an anticoagulated 84-year-old is a major trauma mechanism, and it is the commonest one you will meet in Australia.

The practical core of the module is a list of questions to ask the paramedics BEFORE THEY LEAVE, because that information exists nowhere else. Speed, restraint, ejection, intrusion, fall height, entrapment time, blood loss at scene - and whether anybody else was killed, which is among the strongest predictors of serious injury in survivors and which nobody volunteers.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The spine of the programme. Catastrophic haemorrhage is placed BEFORE the airway, and the reason is arithmetic: a patient can exsanguinate from a femoral artery in the time a competent intubation takes, and an airway is of no use to a patient with nothing left to circulate.

Two rules to carry out of it. Airway management takes precedence over restriction of motion of the cervical spine - ANZCOR says so explicitly, and it resolves the commonest hesitation in trauma nursing. And if the patient deteriorates, you return to the START of the primary survey, not to where you were. The most consistent pattern in trauma mortality review is a team continuing down the sequence while the problem sat at a step they had already passed.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

ANZCOR's sequence, applied to a trauma reception. Direct pressure first - and note that there is no evidence that elevating a bleeding limb helps, which was taught for decades. Then an arterial tourniquet for a limb, then a haemostatic dressing where a tourniquet will not reach.

The highest-yield nursing action in the module is the one most often not done: the time of application must be noted and communicated. The tourniquet is not removed until specialist care, so everybody downstream inherits the clock you started - and the ischaemic duration feeds directly into limb salvage decisions. Also: a venous cannulation tourniquet is not an arterial tourniquet and will make the bleeding worse; and the four places blood hides when there is none on the floor.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The clinical core. Compensation is not improvement - a healthy adult defends their blood pressure until compensation fails, and then it falls off a cliff. A normal blood pressure does not exclude significant haemorrhage, and the pulse pressure is free information in a number everybody charts and almost nobody reads.

Then the national critical bleeding guideline: the eight parameters it requires to be measured early and frequently, which are the nurse's list; the transfusion ratio floor of no lower than 2:1:1, which is a floor and not a recipe; the lethal triad, of which hypothermia is the point nursing can most directly prevent; and the tranexamic acid window, which starts at INJURY rather than at arrival. The most important document in this module is your service's own major haemorrhage protocol, and it is deliberately not in this course.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Primary brain injury happens at impact and nothing you do changes it. Secondary brain injury happens over the following hours and is almost entirely nursing-sensitive - and of its six causes, hypoxia and hypotension carry most of the weight. Which means that in a head-injured patient, the airway and the blood pressure ARE the neurosurgical treatment until a neurosurgeon is available.

Then the most counter-intuitive content in the programme. ANZCOR Guideline 9.1.6, approved April 2026, recommends manual inline restriction of motion rather than a semi-rigid collar, permits a soft collar only as a warning marker, and names the harms: raised intracranial pressure, pressure injuries, pain, and unnecessary motion during the fitting itself. Read the scope carefully - it is a FIRST AID guideline, and the deliverable for a hospital nurse is two questions and a documented answer, not unilateral removal.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The five chest injuries that are found at B or found at post-mortem. Tension pneumothorax is a clinical diagnosis treated immediately - it does not wait for a chest X-ray, and tracheal deviation is a late sign that is frequently absent. In a ventilated patient it presents as rising airway pressures with a falling blood pressure, which gives a rule worth carrying: examine the chest before you adjust the ventilator.

Also: how to tell a massive haemothorax from a tension on percussion note and neck veins, and why the treatments are not interchangeable; why abdominal examination is unreliable in trauma and what follows from that; and traumatic cardiac arrest, where the reversible causes are MECHANICAL and are treated simultaneously rather than in sequence.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

Three groups, and in all three the direction of the error is the same: normal-looking observations are WEAKER reassurance than in a fit adult, not stronger.

Children compensate brilliantly and then decompensate abruptly, so hypotension in a child is a very late sign. Older people may be profoundly shocked at a blood pressure that charts as normal, have their tachycardia blunted by beta blockade, and bleed intracranially from a trivial mechanism - and the story sounds trivial, which is how they end up somewhere quiet. A pregnant patient is two patients, the foetus is compromised before her numbers move, and the best treatment for the foetus is a well-resuscitated mother.

This module states no paediatric vital sign ranges and no weight-estimation formula, deliberately - they vary by age band and they are on your own service's chart.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The secondary survey head to toe, front and back, with an AMPLE history - of which the medication list is the element that most often changes what happens in the next hour.

Then the tertiary survey: a complete repeated examination performed within 24 hours and REPEATED once the patient is awake and able to tell you what hurts, which is where most missed injuries are actually found. A missed injury rate of several per cent is normal without one. And in practice the person who finds it is almost always the nurse - because you wash them, move them, and are the person they tell at 2am. The module's most useful single idea is documenting what was NOT examined and why, because a blank space reads as normal to everybody who comes after you.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

One person speaks and nobody starts. A trauma handover is the only moment the pre-hospital story exists in one place, and it is destroyed every day by three simultaneous conversations. Four things in it can never be reconstructed: the time of injury, the tourniquet application time, the blood loss at scene and the observations at scene.

Also: forensic evidence preserved AROUND clinical care and never instead of it - cut around not through, paper not plastic, and describe the wound rather than concluding a mechanism. Trauma team roles, closed-loop communication and graded assertiveness with a worked example. Family presence, which requires a staff member allocated to them or it should not be offered. And the debrief, which takes ten minutes and is standard practice rather than a special measure.

In this section: the module slide deck, the student learner guide, and the knowledge check. The check is formative - not graded, no attempt limit - and the rationale on every option is the content.

The assessment brief, the printable case study assessment and the printable summative paper. The interactive versions are here too - the case study assessment as a branching activity, and the summative assessment in the platform's own engine.

Five unfolding presentations across 25 branching decisions, formative and not graded - every option carries feedback, including the plausible wrong ones. Then 60 single-best-answer items blueprinted across all eleven modules. 80 per cent to pass, two attempts, and the certificate is issued automatically on a pass. Twenty items are mandatory-correct.

Five interactive tools. Optional, and deliberately excluded from the claimable CPD figure - if you complete them you may claim that time separately as self-directed CPD.

The primary survey sequencer is the core drill: a finding appears, you say which step owns it, and one item tests the rule that deterioration sends you back to the start. Where is the blood going works the four internal sites plus the floor - and includes the adult in whom the answer is never the head. Handover under pressure rehearses the words for four receptions where the information is about to walk out of the door. The collar question applies ANZCOR 9.1.6 where the old teaching and the current guideline diverge. And the scope self-check sorts every activity against your own role.

Three fillable instruments to take to work. These are the deliverables of the programme - the things that exist after it ends.

The trauma reception readiness check is completed before the shift rather than during the resuscitation, and most of it is questions whose honest answer is 'I don't know' - which are the findings. The documentation and handover audit takes ten consecutive records against the essential elements, starting with the four that can never be reconstructed. And the tertiary survey record is the missed-injury defence, built around a column for what was NOT examined and why.

The reflective workbook - fillable, and your CPD evidence, which the NMBA expects you to hold alongside your certificate. The one-page scope of practice card, designed to be printed and kept where you work. And the further reading directory with live links.

Two currency points in the directory are worth reading. The critical bleeding guideline is version 2.0 (4 September 2025) and is under review - while PBM Modules 2 to 6 have been ARCHIVED by the National Blood Authority and must not be cited as current. And ANZCOR 9.1.6 was approved in April 2026, superseding the 2016 edition.