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 |