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Unlike most fables, I’ll put the moral of this story up front:  don’t ask for a trauma team if you aren’t absolutely certain your patient needs one–by which I mean “fits the actual recommended ACS/CDC criteria.”  (Note especially that “car rollover” isn’t considered a high-risk mechanism.  Note also that you are perfectly allowed to take someone to a trauma center for borderline trauma without  actually requesting a trauma team.)

It’s OK to ask for a trauma team–like you, I was trained to ask for one when in doubt.  But now that I’m spending time on the trauma service, responding to trauma alerts and seeing admitted patients, I find that there is more and more reason to not ask for a trauma team whenever I think I can get away with it.

Put simply, having your patient resuscitated by the trauma team is not a benign process.

Maybe you’re not particularly concerned about the indignity of putting a not-clearly-injured person through public nudity and a rectal exam.  Perhaps you don’t even care about health care costs (although since you’re helping pay for someone’s health care somewhere, you really should).  However, there are 2 very real medical risks you should worry about if you want to do what’s right for your patient, if your trauma center is fairly typical (as I like to consider ours):

1. Radiation.  In the last 2 weeks, the number of times I’ve seen a trauma patient not get a head and torso full of X-rays is one.  (It’s rare enough that I remember it specifically.)  Now for an older victim, no big deal–someone who’s 80 isn’t going to develop a cancer from that, at least not quickly enough to kill them.  But it’s definitely a real concern in a 20-year-old.
2. Germs.  Our default on the trauma service is to admit everyone, even if it’s only overnight.  This exposes them to all of the nastiness that is available in the hospital–which is less of a risk for younger, healthy patients than it is older ones, but is a risk nevertheless.

So what to do with all those patients that you think need to be at a trauma center, but aren’t sick enough to need the full trauma team right now?  I guess it depends on your system–some places have a mechanism to have a doc (but not a full trauma team) show up upon EMS arrival for a quick glance at the patient.  If the facility doesn’t have such a response mode, it might be worth calling medical command and saying the doc might want to take a quick look at the patient (just know that if you make a request like that on a recorded line, you’re kind of tying the doc’s hands–so don’t make such a request lightly).  If none of these work, you and (more importantly) your patient might just be totally out of luck, and you both have my sympathy.