A “trauma call” should standardise the in-hospital response to trauma patients. A trauma team is mobilised to receive the patient. Other services (eg: radiology, blood bank etc) may also be notified.
A mandatory trauma call should be placed if any of the following criteria are met
- R40 call – status 1 or 2 trauma patients
- Abnormal physiology*
- Respiratory rate <10 or >29
- Systolic BP <90mmHg
- HR >120 bpm
- GCS < 13
* if recorded at any time from the point of injury
- Injury patterns
- Penetrating injury to the head, neck or torso
- Flail chest
- Airway obstruction
- Suspected complex pelvic injury
- Two or more proximal long bone fractures
- Traumatic amputation proximal to knee or elbow
- Major crush injury
- Penetrating trauma to a limb with arterial injury
- Crushed, mangled, amputated or pulseless limb
- Paraplegia or quadriplegia
- Major burns
- >20% in adults (>10% in paeds), or airway burns
Discretionary trauma calls
A discretionary trauma call can be considered by a senior clinician based on mechanism, physiology, co-morbidities or a combination of these. Examples include:
- Fall > 3 meters
- Entrapment > 30 minute
- Cyclist or motorcyclist versus car
- Pedestrian versus car or train
- Relative hypotension
- Ejection from a vehicle
- Fatality in the vehicle
- Patient anticoagulated or on beta blockers
- Elderly patient with moderate trauma
- Pregnant patient with moderate trauma
- Transfers
Major trauma patients transferred from another hospital to the Emergency Department should be received by the trauma team.
- Multiple casualties
When the Emergency Department is forewarned of the imminent simultaneous arrival of four or more trauma patients, irrespective of their suspected injury severity