Trauma call

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

 

1. R40 call – status 1 or 2 trauma patients

 

2. 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

 

3. 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

 

4. Transfers

 Major trauma patients transferred from another hospital to the Emergency Department should be received by the trauma team.

 

5. 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