Protocols 31–37
Emergency Department Protocol Commons
Consultation Edition, Version 0.9
Phase V addresses seven groups of traumatic, environmental and anatomically focused emergencies in which delayed recognition, uncontrolled bleeding, secondary injury, tissue loss or failure to obtain timely specialist care may lead to death or permanent disability.
The protocols provide structured pathways for major trauma, head and spinal injury, thoracic, abdominal and pelvic trauma, limb-threatening injury, burns, wounds, bites, stings, envenomation, environmental exposure and acute eye, ENT and dental emergencies—from immediate recognition and stabilization through investigation, definitive treatment, reassessment, admission, transfer, observation, rehabilitation planning or safe discharge.
These protocols are intended for professional review and responsible local adaptation. They are not approved clinical policies and must not be implemented without verification against current guidance, local resources, professional scopes of practice, medication formularies, legislation, trauma-system capacity, blood-product availability, imaging and procedural capability, specialist services, referral arrangements and institutional governance requirements.
Download Phase V
The complete phase may be downloaded in either of the following formats:
Download the complete Phase V package — PDF and editable Word copies
Download the Phase V editable Word package for local adaptation
Readers may also review the individual PDF consultation copies below.
How to Review This Phase
Reviewers are not expected to comment on all seven protocols.
Please select the protocols most relevant to your experience and consider:
Clinical safety and accuracy
Medication and dosing safety
Trauma resuscitation and haemorrhage-control pathways
Diagnostic, imaging and treatment feasibility
Procedural, equipment and monitoring requirements
Blood-bank, surgical and specialist capacity
Referral and interfacility transfer arrangements
Rehabilitation and follow-up requirements
Paediatric, maternal and older-adult considerations
Resource-variable and small-island realities
Important omissions or unnecessary complexity
Please submit a separate feedback form for each protocol being reviewed.
Submit feedback on a Phase V protocol
Protocol 31 — Major Trauma and Multiple Injury
This protocol provides a coordinated pathway for patients with major trauma, multiple injuries or suspected life-threatening traumatic injury.
It covers trauma-team activation, catastrophic haemorrhage control, structured <C>ABCDE assessment, airway and circulatory resuscitation, haemostatic treatment, damage-control principles, bedside imaging, definitive imaging, specialist activation, operative or interventional source control, transfer and safe disposition.
Read or download the PDF consultation copy
Protocol 32 — Head and Suspected Spinal Injury
This protocol addresses traumatic brain injury, altered consciousness following trauma and suspected cervical, thoracic or lumbar spinal injury.
It covers spinal motion restriction, airway and neuroprotective management, repeated neurological assessment, imaging and spinal-clearance decisions, anticoagulant reversal, intracranial-pressure concerns, neurosurgical or spinal consultation, concussion care, observation, admission, transfer and safe discharge.
Read or download the PDF consultation copy
Protocol 33 — Thoracic, Abdominal, and Pelvic Trauma
This protocol provides a structured approach to potentially life-threatening injury involving the chest, abdomen or pelvis.
It covers immediate treatment of tension pneumothorax and other critical thoracic injuries, recognition of occult haemorrhage, eFAST and CT imaging, pelvic stabilization, haemostatic resuscitation, serial examination, operative and interventional-radiology pathways, specialist escalation, admission and transfer.
Read or download the PDF consultation copy
Protocol 34 — Limb Injury, Fracture, Dislocation, and Neurovascular Compromise
This protocol addresses traumatic injury to the upper and lower limbs, including fractures, dislocations, open injuries, vascular compromise, compartment syndrome and traumatic amputation.
It covers analgesia, examination and documentation of neurovascular status, reduction, immobilization, wound care, antibiotic and tetanus considerations, recognition of limb-threatening injury, specialist consultation, rehabilitation planning, follow-up and safe disposition.
Read or download the PDF consultation copy
Protocol 35 — Burns, Wounds, Bites, Stings, and Envenomation
This protocol provides an integrated pathway for thermal, chemical and electrical burns; acute wounds; mammalian and human bites; insect and marine stings; and suspected envenomation.
It covers immediate cooling and decontamination, burn-depth and surface-area assessment, airway risk, fluid resuscitation, analgesia, wound management, infection prevention, tetanus and rabies assessment, toxin-specific treatment, antivenom considerations, specialist consultation, admission and transfer.
Read or download the PDF consultation copy
Protocol 36 — Environmental and Exposure Emergencies
This protocol addresses acute illness or injury caused by drowning and submersion, heat, cold, electricity, lightning, hazardous chemicals, radiation, diving, decompression and altitude exposure.
It covers scene and staff safety, decontamination, immediate resuscitation, temperature management, respiratory and cardiac monitoring, recognition of delayed complications, poison-centre or specialist consultation, hyperbaric referral where indicated, observation, admission, transfer and safe discharge.
Read or download the PDF consultation copy
Protocol 37 — Acute Eye, ENT, and Dental Emergencies
This protocol provides a structured pathway for acute eye, ear, nose, throat, facial and dental presentations that may threaten vision, the airway, hearing, dentition or the spread of serious infection.
It covers chemical eye injury, acute visual loss, ocular trauma, epistaxis, airway-threatening ENT conditions, foreign bodies, facial and deep-space infection, dental trauma, odontogenic infection, pain management, specialist escalation, admission, transfer and safe discharge.
Read or download the PDF consultation copy
Submit Feedback
Feedback from emergency clinicians, nurses, pharmacists, surgeons, anaesthetists, ophthalmologists, ENT specialists, dental professionals, allied health professionals, administrators, patient-safety personnel and other relevant reviewers is welcomed.
Please identify:
The protocol number
The relevant section or page
The concern or recommendation
Suggested replacement wording where possible
Supporting evidence or local experience
Whether the issue may represent an urgent patient-safety concern
Submit feedback on the Emergency Department Protocol Commons
Complete Protocol Index
Browse all 59 protocols and download individual PDF or editable Word copies
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Phase VI — Maternal, Paediatric, and Vulnerable-Population Emergencies