Tier 2 Trauma Teams: Using EMS Provider Judgement to Activate Trauma Teams for Patients Without American College of Surgeons Anatomic or Physiologic Criteria

Some high-risk trauma patients present with normal vital signs, masking serious injury. This session examines a Tier 2 trauma team activation (TTA) designed for EMS providers to initiate when concern exists despite stable vitals. Unlike full activations, Tier 2 TTAs enable expedited evaluation without requiring a trauma surgeon response. Data from 153 activations show nearly 60% required admission, with some upgraded on arrival—highlighting the limitations of vital signs alone. Attendees will learn how EMS advocacy drives early recognition of occult trauma and how to implement a multi-tiered activation system that supports clinical judgment and improves patient outcomes.