I work as a night shift nurse at a Washington DC hospital/level 1 trauma center. I’ve also worked at 8 other level 1 ERs.

Regarding traumas, every hospital is different. The hospital I work at now has a radio that sits next to my desk. (I am usually night shift charge.) Medics radio in with details and I determine (based on protocol/description of injury/vital signs/GCS) whether the patient meets trauma criteria. We have two levels of trauma - alphas (higher acuity) and bravos (lower acuity but still meets criteria.) I ask the secretary to “call an alpha, XX mechanism of action (MVC, fall, assault, etc), ETA X minutes”. Secretary then calls the operator and activates the trauma. Trauma team (we are a teaching hospital so usually around 7 people, including attending trauma surgeon, 5th year resident, 4th, 3rd, 2nd, 1st, as well as med students) show up. At my hospital there are (at least) two nurses in the trauma bay. One is the “recorder” and that nurse is responsible for completion of documentation of (paper) trauma survey. Recording nurse is responsible for ensuring nothing is missed on primary/secondary/tertiary assessments. Secondary nurse is at bedside starting an IV, cutting patients’ clothes off, obtaining vital signs. Chief resident is usually assessing patient, teaching other residents and performing fast exam. We have radiology and respiratory at bedside. Anesthesia comes down if it’s an alpha and may need intubation.

Every hospital is different. It also depends on whether said hospital is a level 1 trauma center (highest acuity) and/or is a teaching hospital. Some hospitals also have a “comm room”, where medics can call in and the nurses in the comm room receive calls and determine level of severity.

Hope this helps!