Hospital University of Minnesota Medical Center Policy

Trauma Team Activation Level RED/FULL (Highest Activation Level) - UMMC

Purpose: 1. To define criteria identifying trauma patients who are in need of rapid assessment and potentially rapid interventions. 2. To ensure timely and appropriate evaluation and resuscitation through simultaneous activities of a multidisciplinary team. 3. To identify response time expectations.

Policy: Any patient that presents to the University of Minnesota Medical Center - East bank campus that meets the following criteria will have a trauma team activation level Red/Full called.

Criteria:  EMS Judgment  Decision of ED attending/Charge RN/Trauma MD, APP or RN to upgrade only  Confirmed SBP < 90 systolic in adults at any time  Confirmed age specific hypotension in pediatrics Age mmHG o 6 years + 90 o 2-5 years 80 o 12-24 months 75 o 0-12 months 70  Respiratory distress or airway compromise  Flail chest (known or suspected)  Unstable trauma transfers (respiratory distress, intubated with on-going respiratory issues or receiving blood products)  Penetrating wounds to head, neck, chest, abdomen and/or genitalia  GCS 3-8 related to trauma  Unstable pelvis  C-spine injury with neuro deficit  Traumatic paralysis to include limbs  Tourniquet in place to control hemorrhage  Burns should be diverted enroute to a burn center

Trauma Attending will be present within 15 minutes of patient arrival to the ED or of 15 minutes after notification of a patient upgraded.

The following personnel are expected to respond immediately to an activation:  Resident/APP/Moonlighter MD  Anesthesia  Emergency Department Nurses/Trauma Nurse  Emergency Department MD  Emergency Department Technician  Lab/Blood Bank Staff  Pharmacy  Respiratory Therapy (RT)  Security  X-ray Tech

Procedure:

1. Determine that patient has met Trauma activation criteria. 2. The ED HUC or designee will call the operator at 888. 3. The ED HUC or designee will state a “Trauma Team Activation Level RED.” 4. The operator will digitally and/or overhead page 3x “Trauma Team Activation Level RED.” 5. Universal precautions are expected for all patient care. 6. The Trauma Surgery provider will coordinate care of the trauma patient with the ED Attending. 7. Patients must be accompanied on any transport to radiology by an advanced care provider (APP, MD, DO). 8. Trauma Services will admit patient as appropriate.

Policy Owner:

UMMC Trauma Program Manager

Approved By:

System Director of Trauma Services UMMC Trauma Medical Director

Date(s):

Date Effective: 9/07

Date Review/Revised: 9/12, 9/14, 8/15, 3/18

Related Information

Additional Approvers: UMMC Trauma PIPS Committee 4/18

External Ref: Resources for Optimal Care of the Injured Patient: 2014 American College of Surgeons – Advanced Trauma Life Support

Internal Ref: University of Minnesota Medical Center Trauma Registry