A trauma team is a team of doctors, nurses, and technicians who work in the emergency room of a hospital, treating patients suffering from severe illnesses or injuries that require immediate care. The core of a trauma team consists of ten health-care workers, including the emergency room physician, the anesthesiologist, and two nurses. If an anesthetic assistant is not present, a third nurse can be substituted. Additional personnel, such as a neurosurgeon, can be added to the team if their specialty is needed.
The trauma team leader is responsible for coordinating the activities of the trauma team. He or she decides on the team's course of action, gives instructions to other team members, receives and interprets important information such as the results of investigation procedures, and if necessary consults with additional specialists. The trauma team leader is usually a surgeon, emergency physician, or anesthesiologist.
The anesthesiologist and anesthesiologist assistant are responsible for tracking the patient's condition. They monitor the patient's vital signs and the administration of fluids and drugs. They are responsible for airway control to prevent obstruction of the patient's breathing and for cervical spine control if the patient's injury puts him or her at risk for spinal damage. They also administer analgesics and anesthetics as needed for pain control.
The general surgeon assesses injuries to the patient's abdomen and thorax, and makes any incisions needed to access the thoracic organs, such as the heart and lungs, a process called thoracostomy. If no neurosurgeon is present, the general surgeon assesses the patient's head as well. The orthopedic surgeon assesses the spine, pelvis, and limbs; dresses wounds; stabilizes fractures; and ensures intravenous access. The emergency room physician assists the two surgeons and can also perform some of the same procedures if necessary, increasing efficiency by allowing all three doctors to continue working simultaneously.
The nursing staff assists the physician and surgeons as well as the anesthesiologist if an anesthesiologist assistant is not present. The radiographer performs a series of x-rays, usually starting with the cervical spine and then moving to the chest and pelvis. The scribe records information about the patient, including his or her injuries, vital signs, and test results, as well as the drugs and fluids administered and the names of personnel present. Specialists sometimes brought in to assist trauma teams include radiologists, plastic surgeons, and neurosurgeons, depending on the nature of the trauma being treated.
In the United States and many other nations, trauma teams are trained in a program called Advanced Trauma Life Support (ATLS), also known as Early Management of Severe Trauma (EMST). When a patient arrives, an ATLS-trained trauma team begins a series of procedures to assess and treat trauma patients, with the most time-critical potential threats to life treated first. They starts by checking, and if need be unblocking, the patient's airway, then move on to chest injuries, blood loss, and then a neurological assessment. Finally, they see to the patient's environmental conditions to prevent hypothermia, a common cause of death in people who have suffered severe blood loss. Once the patient's condition is stabilized and the most immediate threats to his or her life have been addressed, a more thorough secondary survey can begin.