Major Incident
Surgical and Trauma Teams

The MISTT Trauma Course  |  QEHB & KASTC  |  10th - 14th November 2018


November 2018 agenda available shortly.

Agenda from May 2018 meeting:


15th May 2018 – Cadaveric Lab – Damage Control in Orthopaedic Trauma

Time Procedure
0900 - 1045 Damage control vascular techniques + Vascular shunts
Proximal control Groin & Lower Limbs
  Proximal control in the upper limbs
Proximal to the axilla (Subclavian) or vascular injury repair & access
  Tea / Coffee Break (30 minutes)
1115 - 1245 Open fractures principles Debride and Stabilise – Ex-Fix application
  Compartment fasciotomy – LL & UL + Ex-Fix and considerations
  Lunch (45 minutes)
1330 - 1515 Resuscitative thoracotomy (left anterolateral thoracotomy and clam shell)
  Repair or stabilisation of atrial and ventricular injuries – The Aorta in the chest
  Tea / Coffee Break (30 minutes)
1545 - 1730 Head & Neck wounds and immediate management principles
  Discussion and review & free practice of above


16th May 2018 – Cadaveric Lab – Damage Control in Orthopaedic Trauma

Time Procedure
0900 - 1030 Damage Control in the Pelvis – Pelvic Packing
  External Fixation to the Pelvis
  Tea / Coffee Break (30 minutes)
1100 - 1245 DCL Part 1
Damage Control Laparotomy (DCL) – The Aorta in the abdomen
  Includes: Splenectomy, Pringle manoeuvre, liver mobilisation/packing, Kocherisation, pancreatic injury
  Lunch (45 minutes)
1330 - 1510 DCL Part 2
The retroperitoneum, Left to right visceral medial rotation, renal repair and nephrectomy
  Temporary abdominal closure/VAC
  Tea / Coffee Break (20 minutes)
1530 - 1730 Escharotomy – Chest & Hands
  Discussion and review & free practice of above


17th May 2018 – Major Incident Awareness

0900-0915 Registration
0915 Welcome and Introduction
  Terrorism, Counter Terrorism, Awareness and Pre-Hospital Response
0930 UK Counter Terrorism
  • What are the threats?
  Major Incident Awareness
  • MI NHS England/ Network Response Structure
  • Gold/Silver/Bronze Command
  • Casualty Regulation and the reality
  Discussion Panel: Ask the Experts
  Mechanism of Injuries from Terrorism Forum
1100 Clinical Guidelines for use in a Major Incident – Commissioned by NHS England
  MOI: Blast and Crush Injury
  MOI: Penetrating Knife Injury and Ballistic Injury
  MOI: CBRN (Chemical, Nuclear, Radiological, Nuclear) Injury
  • What are the threats? -Is your hospital prepared?
  • Signs and Symptoms - Evidence to support the new guidelines
  Discussion Panel: Ask the Experts
1230 LUNCH
  The First Hour (Pre-Hospital and ED) Forum
1330 Emergency Department Triage
  • Latest research making changes to Pre-hospital and ED Triage
  Paediatric Trauma and SMART Triage
  • Essentials of Paediatric trauma and triage
  ED Controller/ CTC (Surgeon Commander) Role
  Surgical Co-ordination, Blood transfusion and IR
1515 Theatre Controller / Critical Care Controller
  • Coordination of multiple polytrauma patients, after Resus and to first operation
  Blood Transfusion /NHSBT:
  • Rapid transfusion, Sustainable transfusion in an MI
  • Organ donation in an MI
  Interventional Radiology:
  • A place for IR in a mass casualty incident
  NHS Logistics:
  • Head of Supply Resilience & Sustainability, Department of Health
  • New plans to assist resupply, anywhere in the UK by existing suppliers (Stryker)
  Discussion Panel: Ask the Experts
1700 Close


18th May 2018 – The Aftermath: Day 1 and beyond of a Mass Casualty Event

0830 Registration
  Lessons Learned from Military Conflicts
0845 Military Assistance to Civilian Authorities (MACA)
  Imaging (CT Traumagram)
  • Whole body imaging
  • Imaging Shrapnel
  Microbiology and BBV
  • Lessons learned from managing 10 years of military wounds
  Preparing for the Surgical Tail
  Ongoing Management of Ballistic Trauma
  • SIRS and Sepsis. The impact on procedures and anaesthesia
  Complex Pain Management in blast/ballistics cases
  Ask the Expert Panel: Discussion and Questions
  Forensics, Media, Staff Welfare and Rehabilitation
1115 Forensics
  • How should items with forensic potential be managed by the trauma team
  Clinical Photography in a Major Incident
  Managing the Media (incl social media)
  Looking after your staff. How teams can be debriefed. What worked, what didn’t.
  Hyperacute Rehabilitation
  • How to assist on day one, creative acquistions
  • Tips to get your patients moving
  Funding Rehabilitation and Ongoing care
  • How serious injuries legal teams can help rehabilitation and fund ongoing care, not available on the NHS and recent cases
  Ask the Expert Panel: Discussion and Questions
1300 LUNCH
  Recent UK Experience
1345 The Manchester Experience
  • First hand accounts and lessons learned Including bereavement – SWAN Nurses
  • The team that delivered the unique Manchester experience
  Clinical Guidelines for use in a Major Incident
  • Commissioned by NHS England
  Discussion: Ask the Panel
1500-1530 Close

Timetable subject to change.