TRAUMA ACTIVATION CRITERIA
Leveling criteria are guidelines only. Leveling should be guided by the
rationale for each level and by clinical judgment.
FULL TEAM
Patient unstable - Need for immediate trauma resuscitation or immediate OR
Team includes: Trauma Surgeon, ED MD, Anesthesia, ED RNs, ICU RN, Lab, Xray, CT Tech, Respiratory, Pharmacy,
Scribe, House Supervisor, Social Services, Admissions
Airway & Breathing
 Intubated patients
 Threatened or compromised airway
 Pneumothorax or ventilation compromise
 Grunting or stridor in child
 Respiratory rate < 10 or > 29 (< 20 infant < 1 yr)
 Flail chest
Circulation
 Systolic blood pressure <90
 Transfer patients receiving blood to maintain vital
signs
Disability
 GCS < 12
 Open or depressed skull fracture
 Paralysis or focal neurologic deficit
Mechanism of Injury
 Burns >20% BSA or to head, face, genitalia
 High voltage injury (including lightening)
 Penetrating injury to torso, neck, head,
or proximal to elbow or knee
Other
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Unstable pelvic fracture
Bilateral femur fractures
Open fractures in multiple trauma setting
Pulseless extremity / threatened limb
Traumatic amputation / mangled limb / crushed /
degloved / impaled
MD or RN discretion
PARTIAL TEAM
Patient stable – Mechanism suggests possible significant injury – need expedited evaluation
Team includes: ED MD, ED RN, Lab, X-ray, Admissions
Injuries Found
 Isolated open fractures
 2 or more proximal long bone fractures
(bilateral femur fractures = Full Team)
 Subcutaneous emphysema
 Possible spinal fractures without CNS
involvement
 Maxillofacial trauma without airway
compromise
Mechanism of Injury
 Auto vs pedestrian / bicycle
 Death in same collision
 Thrown from horse
 MVC w/speed ≥ 45 MPH
 Motorcycle / ATV / snowmobile crash
 Fall > 15 feet
Pediatric falls > twice their height
Consider Activation for High Risk Patients:
 Age > 65 or < 5
 Multiple co-morbidities
 Blood thinners or other bleeding/clotting
disorders
 Ejection from vehicle / rollover
 Major auto deformity, intrusion into occupant
compartment > 12 inches
 Extrication > 20 minutes
 Pregnancy > 20 wks
 Hypo or hyperthermic symptoms
Other
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Stable transfers from outside hospital ED with
injuries resulting from traumatic mechanism
(ED to ED or in-patient < 24 hours)