Trauma Command

February 2026 · 7 min

The Trauma Command module digitises the Advanced Trauma Life Support (ATLS) framework so that every polytrauma patient receives standardised, time-stamped care. From the moment the trauma team is activated, the system guides clinicians through primary survey (ABCDE), secondary survey, and definitive care -- recording every intervention, vital sign, and decision with precise timestamps. The completed worksheet becomes the medico-legal record and feeds directly into the patient chart.

Trauma Activation & Primary Survey

When a trauma case arrives, the triage nurse activates Trauma Command from the triage screen. This triggers a system-wide alert to the trauma team (configurable by role). The primary survey worksheet opens with the ABCDE framework:

• Airway: patency assessment, interventions (jaw thrust, OPA, intubation)
• Breathing: respiratory rate, SpO2, breath sounds, chest injuries, interventions (chest drain, needle decompression)
• Circulation: pulse rate, BP, capillary refill, IV access, fluid boluses, blood product requests
• Disability: GCS score (eye, verbal, motor), pupil reactivity, lateralising signs
• Exposure: temperature, complete undressing log, injury inventory

Every entry is timestamped automatically. Vital signs are captured at configurable intervals (0, 5, 15, 30 minutes) with trend graphs rendered in real time.

Secondary Survey & Injury Documentation

After the primary survey stabilises the patient, the secondary survey captures a systematic head-to-toe examination. Bio-Ecko provides an interactive body diagram where clinicians tap to mark injuries -- lacerations, fractures, burns, penetrating wounds -- with severity grading.

Each injury is classified using ICD-10 trauma codes and Abbreviated Injury Scale (AIS) scores. The system auto-calculates the Injury Severity Score (ISS) from the three highest AIS regions, providing an objective severity benchmark for triage decisions and outcome tracking.

Procedure Logging & Blood Products

All procedures performed during trauma management are logged with timestamps: intubation attempts, central line insertion, tourniquet application, fasciotomy, FAST ultrasound results. Each entry captures the performing clinician, outcome, and any complications.

Blood product management integrates with the Blood Bank module. Emergency O-negative release is supported with one-click authorisation, retrospective cross-match tracking, and automatic incident report generation. The massive transfusion protocol (MTP) can be activated from the trauma worksheet, triggering blood bank preparation of pre-defined component packs.

Stroke & Sepsis Boards

Beyond trauma, similar time-critical protocol boards exist for:

• Stroke Board: door-to-needle time tracking for thrombolysis, NIHSS scoring at presentation and 24 hours, CT/MRI activation with radiology priority alerts, neurology consult workflow
• Sepsis Board: qSOFA scoring, lactate monitoring with re-check reminders, antibiotic administration time tracking (target under 1 hour), fluid resuscitation logging with cumulative volume display

Both boards trigger automated alerts if protocol milestones are missed, and generate compliance reports for quality committees.

Disposition & Handover

Once the patient is stabilised, the trauma lead documents disposition: direct to OT, ICU admission, ward transfer, or inter-hospital transfer. The handover summary auto-generates from the trauma worksheet data -- injuries, procedures, medications given, pending investigations, and outstanding concerns.

For inter-hospital transfers, the system generates a structured transfer form including clinical summary, imaging CD request, blood product requirements, and ambulance request. The receiving hospital can be notified electronically if they are also on Bio-Ecko.

Analytics & Quality Improvement

Trauma analytics track key performance indicators: door-to-CT time, door-to-OT time, primary survey completion rate, ISS distribution, mortality by ISS bracket, and trauma team activation response times. These metrics feed into monthly morbidity-mortality reviews.

The registry also supports national trauma registries and NABH quality indicators. Case reviews can be tagged and flagged for M&M discussion, with the complete timeline available for retrospective analysis.

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