Trauma Team Activation

Original Date: 07/2025

Response Tier Level	Criteria	Personnel
1	Physiologic criteria GCS <10 SBP <90 mmHg (at any time in adults and age-specific hypotension in children) RR <10 or >29 HR >120 Intubated Anatomic criteria Penetrating injury to the head, neck, torso, or extremity proximal to elbow/knee Amputation proximal to the wrist or ankle or a mangled extremity Pulseless extremity after fracture reduction Open book pelvic fracture or prehospital pelvic binder in place Pre-hospital tourniquet application Uncontrolled external hemorrhage Acute paraplegia (0/5 movement in BLE) or quadriplegia (0/5 movement in all extremities) due to trauma Any burn ≥20% TBSA Any burn requiring intubation Trauma patients receiving blood transfusion (by EMS or transferring facility) Respiratory compromise or obstruction requiring intubation in the ED Pregnancy ≥ 20 weeks gestation who meet Level II criteria EM physician discretion	ED Physician Trauma Surgeon Trauma APP Trauma Nurse (Recorder) Trauma Nurse (Bedside) Patient Care Technician Radiology Tech Respiratory Tech Also notified: ED APP ED Charge Nurse (or Clinical Coordinator) OR Charge Nurse SICU Charge RN Anesthesiologist (via OR Charge Nurse or ED Clinical Coordinator) Blood Bank Security Chaplain On call administrator
2	None of the above findings and any of the following: GCS >10 and <14 HR 110-120 Penetrating injury to extremities distal to elbow/knee Burns 10-19% TBSA Motor vehicle crash with death of an occupant, intrusion >12 inches, requiring extrication, ejection from vehicle, or seatbelt sign Auto-pedestrian, auto-bicycle, motorcycle, ATV, watercraft >20 mph impact Falls >15 feet for adults, pediatric falls >10 feet or 3 times the height of the pediatric patient Any patient ≥65 years on anticoagulants with head trauma (excluding aspirin) or fall from higher than ground level EM physician discretion	ED Physician Trauma Nurse (Recorder) Trauma Nurse (Bedside) Patient Care Technician Radiology Technician Trauma Surgeon (if the EM Physician places a consult; urgent consults must be seen within 60 minutes)

Level 1 activations may be downgraded after mutual agreement between ED Physician and Trauma Surgeon following primary and secondary survey and screening FAST, CXR, and/or PXR.

Normal Pediatric Systolic Blood Pressure Parameters
Age	Preterm	Newborn	3 mo	1 yr	3 yr	6 yr	8 yr	10yr	12 yr	14yr
SBP	50-70	60-70	60-70	70-80	76-90	80-100	84-110	90-120	90-120	90-130