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Determine appropriate trauma team activation level based on injury criteria
| Category | Full Activation | Limited Activation |
|---|---|---|
| Physiologic | GCS ≤8, SBP <90, RR <10 or >29, airway needed | GCS 9-12 |
| Anatomic | Penetrating torso/neck, amputation, open skull, flail chest, unstable pelvis | ≥2 proximal long bone fractures |
| Mechanism | Fall ≥20 ft, crash ≥40 mph, ejection, death in vehicle | Fall 10-19 ft, crash 25-39 mph, pedestrian struck, motorcycle crash |
| Special | - | Age ≥55, anticoagulation, pregnancy, burns with trauma |
Assess patency, consider C-spine precautions, definitive airway if needed.
Assess ventilation, treat tension PTX, flail chest, hemothorax immediately.
Control hemorrhage, fluid resuscitation, massive transfusion if needed.
GCS, pupil exam, neurologic assessment, consider head CT.
Complete exposure for full exam, prevent hypothermia, log roll for back exam.
Bedside ultrasound for free fluid. Rapid assessment for intra-abdominal bleeding in unstable patients.
Portable AP for pneumothorax, hemothorax, widened mediastinum, fractures.
If mechanism suggests pelvic injury. Guides need for pelvic binder, angioembolization.
Head, C-spine, chest, abdomen, pelvis for stable patients with major mechanism.
Direct pressure, tourniquets for extremities, activate MTP, consider REBOA.
1:1:1 ratio PRBC:FFP:platelets. Goal-directed with TEG/ROTEM if available.
Stop bleeding, control contamination, temporary closure. Resuscitate in ICU.
Warm fluids, forced-air warmers, increase room temperature during resuscitation.
Trauma team activation is a pre-hospital alert system that assembles a multidisciplinary team in the emergency department before the patient arrives. This ensures appropriate resources and personnel are immediately available for critically injured patients.
Full activation mobilizes the complete trauma team including attending-level trauma surgeon, anesthesia, multiple residents, and ancillary staff for the most critically injured. Limited activation involves fewer personnel (often resident-level) for moderate injuries that still warrant coordinated trauma response.
Yes, limited activations can be upgraded to full activation if patient condition deteriorates or additional injuries are discovered. Conversely, full activations can be downgraded if initial assessment reveals less severe injuries than anticipated.
The golden hour refers to the critical first 60 minutes after traumatic injury when prompt treatment significantly affects outcomes. This emphasizes importance of rapid prehospital care, transport, and immediate definitive management of life-threatening injuries.
MTP is a predetermined plan for rapid delivery of blood products in fixed ratios (typically 1:1:1 of packed red cells, fresh frozen plasma, and platelets) to patients with life-threatening hemorrhage. Early activation improves survival in severely bleeding trauma patients.
Elderly patients (≥55-65) have increased trauma mortality even with similar injury severity. Contributing factors include limited physiologic reserve, comorbidities, medications (especially anticoagulants), and decreased ability to compensate for blood loss. Lower activation threshold is warranted.
This calculator provides guidance on trauma team activation based on standard criteria but should not replace clinical judgment or institutional protocols. Local trauma center capabilities, resources, and activation criteria may vary. All trauma management decisions should involve qualified trauma personnel and follow ATLS principles.