CCS Mnemonic: Orders for a Case of Trauma

A Case of Trauma can often be a TRAUMATIC EXPerience - not only to the patient but also to the doc since so many different orders need to be taken care in pretty less time.

Lets use the phrase "TRAUMATIC EXPerience" to help us remember the orders to keep in mind on the USMLE Step 3 CCS , once you have done the basic Stabilization (ABC):

Note:
1. These orders are not necessarily in the right order, you can change the sequence on the CCS screen after you type them out...
2. Not all orders will be applicable to some cases - this mnemonic is to be used as a guideline

"TRAUMATIC EXP"

T - Typing + Cross Matching of Blood
R - Routine Labs [CBC, BMP, LFTs]
A - Alcohol levels, blood + ABG (trauma can result in lactic acidosis)
U - Urine Analysis + Urine Drug Screen if Pt. known drug abuser
M - Morphine for pain (Meperidine if biliary / pancreatic system injury suspected)
A - Amylase for Abdominal Injuries
T - Transfer to ICU / Ward
I - IV Fluids
C - Consult Surgery, Orthopedics, etc ; CT-scans if Pt. Stable OR bedside USG if not

E - EKG 12 Lead
X - Xray Relevant
P - PT / PTT



Again, these orders are AFTER the basic first orders like Oxygen, Endotracheal tube if needed, Continuous BP Monitoring, Pulse Oxy, IV access + Cervical Spine Immobilization + Physical Examination.

Additions, Suggestions and Modifications are welcome - leave us a comment !