Table 2: Trauma team activation levels and criteria.

Full Trauma Team Activation (1st Level)

 Limited Trauma Team Activation

(2nd Level or ACT/Transfer Alert)

Trauma Consult

Absent from Trauma Services

Age 65 and any clinical finding:

·   SBP < 110

·   Penetrating injury

·   GCS deteriorating ≥ 2 points

·   Transfer pt receiving blood to maintain hemodynamic stability

·   Intubated pt transferred from scene

·   Intubated pt with resp. compromise from outside facility

·   Resp. compromise/emergent airway

·   Acute paralysis

·   GCS < 14; Verbal ≤ 3; Motor ≤ 5

·   GCS < 15 with suspected TBI

·   Chest wall instability/deformity

·   Abdominal tenderness

·   Femur fracture, ≥ 2 proximal long-bone fractures

·   Crushed/degloved/mangled/pulseless extremity.

·   Amputation proximal to wrist/ankle

·   Suspected pelvic fx

·   Open or depressed skull fx

·   Falls (> 20 feet)

·   High-risk auto crash

o   Passenger compartment intrusion

o   Ejection from automobile

o   Death in passenger compartment

·   Auto versus pedestrian/bicyclist thrown, run over, or with significant (> 20 mph) impact.

·   Pedestrian struck by MVA

·   Multiple injured body regions

·   Motorcycle crash > 20 mph

·   20% BSA burn

·   Hypothermia with core temperature of ≤ 32 °C

·   GCS ≥ 13 on anticoagulation/antiplatelet agents excluding ASA/bleeding disorder with MOI of fall within 24 hours and history/evidence of striking head.

·   ACT ALERT will consist of the DEM provider evaluating pt within 15 mins and Surgical Resident responding to the DEM within 30 mins.

·   Transferred from outside facility, meet higher activation criteria

Trauma Resident/Service will be consulted by DEM physician when trauma injuries or potential injuries are identified that require further evaluation.

Response within 30 minutes of notification.

Trauma Services are not inquired regarding the care of a patient.

Note: SBP: Systolic Blood Pressure; GCS: Glasgow Coma Score; pt: Patient; resp: Respiratory; fx: Fracture; mph: mile per hours; MVA: Motor Vehicle Accident, BSA: Body Surface Area, ASA: Aspirin, DEM: Department of Emergency Medicine