An organised response to trauma care has been shown to work throughout the developed world with improvements in morbidity and mortality. To achieve this organised trauma care regionalisations of trauma systems have occurred and organisation of hospital services has been undertaken. One of the singular most important aspects of trauma care is the initial resuscitation. The initial resuscitation is undertaken by a trauma team. Most Australian Hospitals have a trauma team. This team can vary from 2 to 3 members in a rural hospital to 15 members in a major trauma service.

   The numbers are not the crucial aspect to a trauma team, it is the structure, organisation, team work and communication that will determine an improvement in patient care. In general a trauma team requires a trauma team leader working with the members of the team to predetermined roles. It is anticipation and preparation, with good communication that will allow the team to function properly. Anticipation and preparation for an impending trauma arrival requires good prehospital communication. Ideally the hospital communication system should be based in the receiving resuscitation area and should avoid if possible going through third parties.

   In this review of the trauma team two trauma systems will be outlined, one for the Rural/Urban Hospital and a system for a Major trauma service. Starting with the major trauma service. In general major trauma services will receive between one and three trauma team activations per day. The criteria for trauma team activation vary from hospital to hospital. The aim of the trauma team response is to treat the most seriously injured patient. A recent review of trauma system monitoring by the Trauma Systems Advisory Committee in New South Wales has determined that the number of seriously injured patients being assessed by a trauma team has fallen to approach only 90% of those with an injury severity score of 16 or greater are attended by a trauma team.

   At Liverpool Hospital we use a singular response activated on the basis of history, vital signs and injury.

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