Trauma and ED Roles and Responsibilities

Original Date: 07/2025

Trauma Activation Notification Process:

The trauma team will be notified via Pulsara. The procedure is as follows:

  1. When the Emergency Department triage nurse is notified via Pulsara by EMS or at patient arrival, the triage nurse will activate a Level 1 or Level 2 trauma team activation (TTA) according to the activation criteria via Pulsara.
  2. For patients still en route, the triage nurse will call a TTA upon identifying that the incoming patient’s condition meets the criteria. He or she will not wait for the patient to arrive in the emergency department before activating the team.
  3. The trauma team activation will be sent to all trauma team members who need to respond according to the level of trauma and to the Unit Clerk.
  4. The Unit Clerk pages overhead in the emergency department “Trauma Level [1 or 2] Emergency Department.”
  5. Trauma team members assemble in the emergency department immediately. Please see Trauma Activation Policy for team members who respond for Level 1 and Level 2 trauma activations.

Roles and Responsibilities of the Trauma Team:
General Pre-Arrival Preparation

All trauma team members who anticipate direct patient contact in a Level I Trauma Activation will don protective personal equipment (PPE) that includes a protective gown, gloves, shoe coverings, protective mask, goggles/glasses, and head cover. For Level II Activations, don PPE as indicated for patient mechanism of injury and exposure.

Responsible Party Action
EMS
(If applicable)
  1. Provide accepting facility with pre-arrival notification/report
  2. Upon arrival to facility, give a verbal report including Mechanism of Injury (MOI), all identified injuries, vital signs, and pre-hospital treatments with the ED physician/trauma surgeon, and any available trauma team members
  3. Assist in moving the patient to the ED stretcher and remove EMS equipment from the room
  4. Non-essential personnel are to exit the room with the lead EMS provider remaining to answer any follow up questions before departing
ED Clerk
  1. Contact OB MD and RN by phone
  2. Assist trauma team as needed 
Triage Nurse
  1. Initiate trauma activation via Trauma Notification Process as listed above as requested by EMS/Physician/RN
Patient Access
  1. Register the patient (if not pre-registered)
  2. Confirm the trauma alpha numeric number
  3. Create the patient identification bracelet and patient labels, then give to charge nurse (if not pre-registered).
ED Physician
  1. Perform initial triage, evaluation, and stabilization in the absence of the trauma surgeon
  2. Initiate a Level I or Level II Activation as appropriate
  3. For a Level I activation, perform a rapid primary survey (including airway assessment/management and identify the need for the difficult airway cart if applicable)
  4. For a Level I activation, perform the Focused Assessment with Sonography for Trauma (FAST) exam
  5. Request consults as needed
  6. Function as the team leader, direct, coordinate, and administer care of the trauma patient until the arrival of the trauma surgeon, if applicable
  7. Give report to the trauma surgeon upon his/her arrival, if applicable
  8. Assist in the care of the patient as needed after the arrival of the trauma surgeon, if applicable
  9. Maintain open and active communication with the trauma team
Trauma Surgeon
  1. Will be present in the Emergency Department within 15 minutes of notification for a Level I activation, or 60 minutes for a Level II activation, if a consult is requested.  Upon arrival to the Emergency Department he/she will assume primary responsibility for the care of the trauma patient 
  2. Direct and coordinate the evaluation and diagnostic management of the patient throughout the entire ED visit
  3. Request and initiate consults as needed
  4. Maintain open and active communication with the trauma team
  5. Coordinate transition from the emergency department to testing, procedures, and/or to the next level of care
  6. Evaluate team performance and patient care outcomes
Trauma Recording Nurse
  1. Prepare trauma room for patient’s arrival and assure readiness of supplies
  2. Place trauma orders
  3. Document all trauma team member names, notification times, and arrival times, on the Trauma Activation Record (Addendum A)
  4. Receive and document report from pre-hospital personnel 
  5. Accurately complete the trauma primary and secondary assessments.
  6. Document in the electronic medical record the arrival date, time, and attendance of all trauma team members.
  7. Ensure serial VS are collected
  8. Maintain open and active communication with the trauma team
  9. Assist the Trauma Bedside Nurse as needed
Trauma Bedside Nurse
  1. Apply and confirm the patient labels and identification bracelet (if pre-registered).
  2. Apply monitoring devices and collect initial and ongoing vital signs. Obtain a manual blood pressure as requested
  3. Obtain/label/send lab samples within a timely manner. If unable to obtain blood sample, notify the ordering physician
  4. Insert NG/OG/Foley as ordered
  5. Administer medications as ordered
  6. Assist with physician/nursing interventions
  7. For Level I and Level II Activations, accompany and monitor the patient during all transfers to/from emergency department, including diagnostic testing
  8. Maintain open and active communication with the trauma team
Patient Care Tech / Paramedic
  1. Place allergy band on the patient (blood band if applicable)
  2. Place 2 large bore IVs
  3. Obtain/label/send lab samples within a timely manner. If unable to obtain blood sample, notify the ordering physician
  4. Disrobe patient and apply warming measures
  5. Place the patient on portable monitoring devices for any transports to/from emergency department, including diagnostic testing
  6. Collect belongings and give to security, if needed.
  7. Maintain open and active communication with the trauma team
ED Charge Nurse
(or Clinical Coordinator)
  1. Ensure the Trauma Activation process has been completed
  2. Identify person to fetch MTP cooler, if activated
  3. Assign staffing roles and provide additional support as indicated
  4. Obtain additional equipment as needed
  5. Communicate lab and diagnostic results to team leader as they become available
  6. Maintain open and active communication with the trauma team
  7. Ensure team compliance with universal precautions/PPE/lead vest with thyroid shield
  8. Monitor and reinforce traffic control in room and limit attendance to only essential care personnel
  9. Ensures trauma patient has ID bracelet placed on patient
Operations
Administrator
(Level 1 trauma activations)
  1. Assist with greeting family and provide a place of privacy
  2. Communicate with Cath Lab, OR, and/or SICU to prepare for patient, if indicated.
  3. Maintain open and active communication with the trauma team
  4. Monitor and evaluate the trauma team response
  5. Monitor and reinforce traffic control in the room 
  6. Evaluate staffing needs and coordinate bed availability for the trauma patient
Respiratory Therapist
  1. Assist with airway control, prepare equipment, assist with intubation, and maintain a secured airway
  2. Obtain arterial blood gases and communicate results to team leader
  3. Ensure oxygen and ventilation equipment is available for transport of patient
  4. Maintain open and active communication with the trauma team
Radiology Technologist
  1. Obtain images as requested 
  2. Assist the trauma team in arranging for all subsequent radiological studies
  3. Maintain open and active communication with the trauma team
Chaplain
  1. When a consult is requested, assume the role of the liaison with all family/visitors. Contact any individuals per patient request
  2. Maintain open and active communication with the trauma team.
Security Officer
  1. Monitor, reinforce, and assist ED in limiting attendance to only essential care personnel. Allow family members to room after clearance given by physician.
  2. Will be informed of potential forensic situations
  3. Assume the liaison role with law enforcement
  4. Ensure safety of team members and patient
  5. Maintain open and active communication with the trauma team
  6. Secure patient belongings upon request
  7. Secure helipad area as needed
OR Nurse
(Level 1 trauma activations)
  1. Assess possible surgical needs of patient and inform the surgery department
  2. Maintain open and active communication with the trauma team