Trauma team
Multidisciplinary team treating severely injured patients under a team leader.
When a severely injured patient is on the way to a trauma center, a specialized team assembles before their arrival. This multidisciplinary group, led by a designated team leader, follows a strict protocol to assess and treat the patient immediately upon arrival. The team leader, typically an experienced physician or trauma surgeon, stands at the foot of the bed, oversees all activity, and makes every diagnostic and treatment decision. They determine the patient’s condition, direct other members, communicate with the operating room and radiology, and manage the medical record.
The primary physician conducts two surveys. The first is a rapid check for life-threatening issues—airway obstruction, breathing problems, shock, or central nervous system injury—focusing on the airway, cervical spine, breathing, circulation, neurological status, and exposure. If the patient is stable, a secondary, head-to-toe exam follows, including a history (allergies, medications, past medical history, last meal, and events leading to the injury) and a physical exam of the head, face, cervical spine, chest, abdomen, pelvis, genitourinary area, back, and extremities. If the patient is unstable, the secondary survey is skipped, and they go straight to the operating room or trauma center. The primary physician announces findings aloud so the scribe can record them.
The airway team, made up of one or two practitioners (such as emergency physicians, anesthesiologists, respiratory therapists, critical care surgeons, or CRNAs), focuses on maintaining the patient’s airway and intubating if needed. They also communicate with the patient and answer questions. One or two trauma nurses stand on either side of the patient, handling ECG, oximetry, blood pressure monitoring, IV access, clothing removal, fluid administration, blood draws, and medications. A radiographer—usually an X-ray or CT technologist—removes jewelry, positions the patient, and ensures radiation safety for all staff.
A social worker or chaplain identifies the patient, contacts and greets the family, and provides communication, spiritual guidance, and support. A recorder or scribe, often a nurse, documents every resuscitation step, vital sign, and procedure performed. Medical students, supervised by a senior resident, may perform tasks like laceration repairs, IV insertion, Foley catheter placement, arterial blood gas draws,
- field
- Trauma medicine
- known_for
- Multidisciplinary assessment and treatment of severely injured patients
- composition
- Team leader, primary physician, airway team, trauma nurses, radiographer, social worker or chaplain, recorder/scribe, medical student
- activation
- Varies by facility; based on location, resources, and patient criteria
Lore & Background
The trauma team is composed of several key roles. The team leader, usually an experienced physician or trauma surgeon, makes all diagnostic and therapeutic decisions, directs other members, and stands at the foot of the patient. The primary physician performs the primary and secondary surveys, calling out findings for the scribe. The airway team, consisting of one to two practitioners, maintains the patient's airway and intubates as necessary. Trauma nurses handle ECG, oximetry, blood pressure, IV access, clothing removal, fluids, blood draws, and medications. The radiographer removes jewelry, positions the patient, and ensures radiation protection. A social worker or chaplain communicates with the patient's family, and a recorder/scribe documents all steps. Medical students, under supervision, may perform various procedures depending on hospital protocols.
Reader's Guide
Trauma teams reduce the time between emergency department arrival and necessary steps such as CT scans and operating rooms. Patients with traumatic injuries not treated by a trauma team have increased mortality. Teams are assessed by video, simulators, and third-party observers. Video review is efficient for identifying errors like poor communication and failure to coordinate, though it cannot review vital signs without a dedicated monitor and raises confidentiality issues. Simulators allow procedures to be stopped mid-procedure for learning without risk, but may be difficult to use. Third-party observation is effective for assessing one member but less so for monitoring all, and may yield biased data. Each hospital generates its own trauma team activation criteria, which should be easy to understand and constantly evaluated.
Did You Know?
- The team leader stands at the foot of the patient and oversees all activities.
- The primary physician performs a primary survey for life-threatening injuries and a secondary survey for non-life-threatening conditions.
- The airway team may include emergency medicine physicians, anesthesiologists, respiratory therapists, critical care surgeons, and CRNAs.
- Video review is one of the most efficient methods of review because team members can see errors in real time.
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