Trauma Team

A Trauma team is a group of healthcare workers who tend to seriously ill or injured patients who arrive at a hospital emergency department. The team is composed of a number of specific roles, with a typical team consisting of:

• Team Leader - Usually an anesthesiologist or emergency physician, sometimes a general surgeon.
• Anaesthetist - Outside of the United States, anaesthetists play a central role in trauma. They manage the patient's airway, monitor vital signs and fluid administration. Often they are trauma team leaders in the UK and some choose to have specialist trauma training as part of their training programme. Due to their extensive skills in trauma and critical care they are usually the doctor who carry out transfers. In the United States emergency physicians fulfill this role and anaesthetists take over patient care once a patient is stabilized and has been transferred to the operating room.
• Anaesthetic Assistant
• General Surgeon
• Orthopaedic Surgeon
• Emergency Physician
• Respiratory Therapist
• Two Nurses. (Three if no anaesthetic assistant)
• In some hospitals, EMTs or Paramedics are used as technicians for vascular access and lab procedures or microscopic features. In others, a Paramedic may actually take on the same duties as a Nurse, depending on the hospital's policies and state laws (Such as in Tennessee, where in-hospital Paramedics have similar scope to an RN.)
• Radiographer
• Scribe - a technician who records and documents specifics of patient care

Other specialities can be added depending on the nature of the injury, for example a neurosurgeon will attend if there is a serious head injury. All staff should be trained in Advanced Trauma Life Support techniques. Each hospital will have a list of criteria that require the activation of the trauma team, such as a fall of over 6 meters or a fracture of 2 or more bones.

The ATLS is designed such that the lone doctor can safely look after a multiply injured patient. Tasks are performed in sequence, one after the other. This 'vertical organization' is the least efficient method of proceeding, and where more than one member of staff is available, a team approach is usually employed. This 'horizontal organization' has been shown to lead to significant reductions in resuscitation times.

The trauma team is ideally made up of a group of doctors, nurses, operating department assistants, radiographers and other support personnel who have no other commitment that day than to receive and treat trauma patients. Obviously this is a very expensive arrangement, and most hospitals cannot afford this level of cover. If the doctors involved are residents, senior consulting staff should be immediately available if necessary. Many centres now have their trauma teams led by consultants.