A. Trauma Team Activation
Lyndon B. Johnson General Hospital Trauma Services Department
Guideline/Protocol Number: T24
Guidelines and Protocols
TITLE: TRAUMA TEAM ACTIVATION
PURPOSE:
The purpose of this policy is to provide guidelines to activate and assemble the trauma team in order to facilitate the care of critical or seriously injured patients who require rapid, organized trauma resuscitation, evaluation and stabilization to promote optimal outcomes. It also serves to provide triage guidelines for adult and pediatric patients
PROCESS:
I. TRAUMA TEAM ACTIVATION GUIDELINE A. The criteria for activation of the trauma team is clearly defined and posted at the Emergency Center triage desk and in the Shock Rooms. B. The trauma team may be activated prior to arrival of patients in the Emergency Center based on the EMS pre-hospital assessment. C. The surgical attending, surgical resident, EC Attending, EC resident, charge nurse, triage nurse, shock room nurse, or Trauma Services staff may activate the trauma team. D. The person initiating the trauma activation will call the page operator to group page the trauma team and will specify the code of activation required. This person will also activate the trauma pagers with a pre-scripted text and detailed information. 1. e.g. “Code 1 or 2, Adult or Pedi., Room, Mechanism of Injury, Vital Signs” E. Test pages will be sent at 0700 and at 1900 by the Ambulance Triage Nurse. If a test page is not received at these times, then the pager holder should report this to the ambulance triage nurse and to physician services. 1. e.g. “Test Page” Page 1 of 6
Lyndon B. Johnson General Hospital Trauma Services Department
Guideline/Protocol Number: T24
Guidelines and Protocols
F. The page operator will announce the trauma activation on the overhead paging system. 1. e.g. “Medical Alert: Adult Trauma Code 1 to Shock Room 1” G. Trauma team member notification and arrival times will be documented in the EPIC “Trauma Narrator” Staff arrival section. H. Trauma team members will badge in when they arrive at the badging station outside of the Shock Room. I. Trauma team members will be activated for all patients who meet the following criteria: 1. Code 1 (moderate/major): life threatening injuries and/or unstable vital signs. potentially life threatening injuries with presently stable vital signs 2. Code 2 (minor): Significant mechanism of injury with potentially life threatening injuries with presently stable vital signs. 3. Injuries meeting activation criteria should have occurred within the past 24 hours. There may be instances in which a patient had an injury greater than 24 hours and may need to be activated. A trauma consult should be considered on all unstable trauma patients.
Page 2 of 6
Lyndon B. Johnson General Hospital Trauma Services Department
Guideline/Protocol Number: T24
Guidelines and Protocols
II. TRAUMA TEAM ACTIVATION CRITERIA
Page 3 of 6
Lyndon B. Johnson General Hospital Trauma Services Department
Guideline/Protocol Number: T24
Guidelines and Protocols
III. TRAUMA RESPONSE TEAMS PER TRAUMA CODE LEVEL AND RESPONSE TIME REQUIREMENTS (FROM ACTIVATION) A. CODE 1
Attending Trauma Surgeon* ≤15 minutes
EC Attending* ≤10 minutes
Chief Surgery Resident As needed
Senior Surgery Resident As needed
Junior Surgery Resident ≤15 minutes
Shock room Nurse(s)* (at least 2 initially) On arrival
Charge Nurse* ≤10 minutes
Radiology Technician* ≤15 minutes
Trauma Program Manager/Director and/or Trauma Coordinator As needed
Respiratory Care Therapist* 15 minutes
Specialty Consult (as requested) ≤60 minutes
Chaplain (as requested) As needed
Page 4 of 6
Lyndon B. Johnson General Hospital Trauma Services Department
Guideline/Protocol Number: T24
Guidelines and Protocols
B. CODE 2
EC Attending* ≤30 minutes
Shock room Nurse(s)* On arrival
Trauma Program Manager/Director and/or Trauma Coordinator As needed
Specialty Consult (as requested) ≤60 minutes
*Denotes a required member of the activation team. Other members may respond as needed. EC Attending is primarily responsible for the patient until Surgery team member arrives. Trauma Surgery Consult patients do not require activation page, but will be included in the trauma registry for performance improvement monitoring. Consults should not replace trauma activations.
A Trauma Code may be activated and upgraded (upon completion of primary survey) and can be done by any member of the trauma team depending upon patient’s condition related to Trauma Team Activation during primary or secondary assessment .
Once a trauma code is activated, it cannot be downgraded.
Page 5 of 6
Lyndon B. Johnson General Hospital Trauma Services Department
Guideline/Protocol Number: T24
Guidelines and Protocols REFERENCE / BIBLIOGRAPHY:
OFFICE OF PRIMARY RESPONSIBILITY:
LYNDON B. JOHNSON HOSPITAL TRAUMA SERVICES
REVIEW / REVISION HISTORY
Review/ Revision Date (Indicate Version # Effective Date Reviewed or Revised) Approved by: (If Applicable) 03/17/20 8 03/17/20 Trauma Committee 02/21/17 7 02/21/17 Trauma Committee 10/21/14 6 10/21/14 Trauma Committee 10/16/12 5 10/16/12 Trauma Committee 06/19/12 4 06/19/12 Trauma Committee 09/23/11 3 09/23/11 Trauma Committee 09/15/08 2 09/15/08 Trauma Services
Page 6 of 6