Trauma Team Activation

The Trauma Nurse Scribe is responsible for assembling all the appropriate documentation forms and completing the trauma flow sheet. In addition to vital signs and exam findings, the flow sheet should record all decisions and events. This nurse receives phone calls from the Blood Bank and Operating Room, communicates laboratory and radiology orders/results between the Trauma Surgeon and appropriate personnel, and makes the Emergency Department Charge Nurse aware of any staffing needs.

A chaplain or a social worker is an indispensable part of the trauma team. This person acts as a liaison between the family, patient and the rest of the trauma team. He or she positively identifies the patient and makes contact with the patient's family. The chaplain has the role of spiritual leader for the patient and family and frequently fills the role of counselor. The Social Worker may be utilized for crisis intervention, provide assistance with obtaining outside services or agencies, and/or facilitate transfer processes.

The Trauma Surgeon performs the initial patient assessment to identify life-threatening injuries. The surgeon is the team leader; he or she directs procedures to be performed, dictates what diagnostic tests will be done in what order, directs personnel to complete specific tasks, and records the major findings and treatment plan in the medical record

The initial responsibilities of the Trauma Primary Nurse include connecting the cardiac monitor, blood pressure cuff, and pulse oximetry sensor to the patient and obtaining measurements. He or she quickly assesses intravenous access, making adjustments as needed, and may obtain blood samples or administer blood products. The trauma nurse is responsible performing point of care testing as directed by the Trauma Surgeon, administering medications, inserting Foley catheters, assisting with splints or dressings, and accompanying the patient to diagnostic studies or other treatment areas.

The Trauma Technician removes the patient's clothing, establishes IV access as needed, and may obtain blood samples. The technician assists with transferring the patient from the gurney to the trauma litter and removing the spine board. He or she assembles equipment and assists the Trauma Surgeon and Primary Nurse as needed with splints, dressings, or other procedures.

The CRNP supports the Trauma Surgeon, assists with procedures, the secondary survey, documentation, history and physical exam, and physician orders

The Emergency Medicine Physician communicates with prehospital personnel to obtain information related to mechanism of injury, physiologic status, presence of anatomic injury, and therapeutic interventions, if any, performed in the prehospital phase. He or she communicates this information to the Trauma Team prior to the patient's arrival, and functions as trauma team leader in the event of a Trauma Alert until the Trauma Surgeon arrives. The Emergency Medicine Physician then assumes responsibilities as requested by the Trauma Surgeon, including assisting with airway management and interpreting EKG findings.

The Respiratory Therapist assists with airway management and emergency ventilation. He or she sets up appropriate equipment for oxygen administration or mechanical ventilation, prepares and turns on suction devices, and connects the patient to the ventilator if necessary. The therapist provides oxygen and other necessary equipment for transfers, draws arterial blood for blood gas analysis, monitors oxygen saturation and end-tidal CO2 as indicated.

The Anesthesiologist or CRNA is responsible for airway management and administers medication under the direction of the Trauma Surgeon. He or she is responsible for initiating documentation upon arrival to the Operating Room and maintaining documentation until post-operative disposition. The Anesthesiologist or CRNA may assist with establishing IV access and hemodynamic monitoring, reporting any changes to the Trauma Surgeon during the operative phase.

A Radiology Technician responds to the trauma resuscitation room with a portable x-ray machine and appropriate cassettes. This technician is responsible for positioning the patient, insuring that jewelry and other artifacts are clear from the field, and that all practitioners are adequately covered from exposure. He or she prepares for and performs all x-rays as specified by the Trauma Surgeon, and contacts the Radiologist on call if indicated.