Here at VCUHS, there is a two tier activation. Essentially, any problem with the primary survey (ABC or D) they get the highest alert, and any issues such as mechanism, co-morbid factors, or high potential injury patterns (i.e. 2 long bone fx's, etc.) get a reduced response. About the only difference between the two is that you get a Trauma Attending with the higher alert vs. a Chief or Sr. Resident, the rest of the team stays consistent. The triage nurse can make the call based on report, or when unsure will confer with ED Physician.
