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