GO TEAM - Emergency Medical Services Office

As the primary adult trauma resource center for the State of Maryland, the R Adams Cowley Shock Trauma Center's mission is to save lives and reduce the disability of critically ill and injured persons in greater Maryland. The Trauma Center recognizes that there are times when victim entrapment will delay transport to definitive care. In these circumstances, the Trauma Center maintains an advanced resuscitative team capable of responding to the scene of seriously injured patients. This physician-led team complements Maryland's Statewide EMS System by providing critical care and surgical services that are typically considered beyond the scope of prehospital emergency care.

Scene incident commanders may request a GO-TEAM response for patients with suspected life-threatening injuries when extrication times are estimated to exceed one hour.

In situations where preliminary reports suggest that a victim's condition may require the GO-TEAM, but the extent of the rescue operation is unknown, a request can be made to put the Team on alert. The purpose of the alert status is to reduce the Team's response time. In this circumstance, the Team would be assembled but not dispatched until an initial on-scene assessment determines that the Team is needed.

More about the GO-TEAM

When dispatched, the GO-TEAM serves as a specialized component of Maryland's statewide emergency medical system. The Shock Trauma GO-TEAM is composed of an attending physician (anesthesiologist, surgeon, critical care medicine specialist) and a certified registered nurse anesthetist.

Team members undergo a core training curriculum that includes field surgical care, State EMS protocols, scene safety, helicopter safety, hazardous materials awareness, radio communications, incident command, vehicular rescue, emergency vehicle operations and field operations. Additional ongoing training includes:

• Use of self-contained breathing apparatus (SCBA)
• Supporting closed space, trench, and high elevation rescue operations
• Techniques for farm equipment rescue
• Water rescue, including personal water craft operations
• Assisting with law enforcement tactical operations

Any incident commander may request the GO-TEAM through EMRC/SYSCOM, through his/her local fire dispatch board, or by calling Maryland ExpressCare directly at 410-328-1234. A trauma-line consult with the attending trauma surgeon on-call is requested if possible to help prepare the team prior to arrival at the scene. Whenever possible, the Team is composed of personnel located within the Trauma Center. In some circumstances, it is necessary to utilize on-call attending physicians, who respond to the scene directly.

Once on the scene, the GO-TEAM reports to the incident commander for integration into the rescue operation. The GO-TEAM operates under the operational command of the scene incident commander The on-scene trauma attending physician assumes responsibility for medical decisions for patients under the Team's care. The GO-TEAM works closely with on-scene emergency medical and rescue personnel to provide patient care. Once extricated, patient transport is accomplished to the closest appropriate trauma facility as determined by the GO-TEAM attending physician.

The GO-TEAM's Capabilities

These include the following:

• Assess the extent of injury and determine potential consequences that delays in time to definitive care might have on patient outcome. This information is provided to rescue personnel so that they may better plan the pace and type of rescue.
• Perform advanced airway maneuvers, including surgical cricothyrotomy and mechanical ventilation.
• Perform chest tube decompression of hemopneumothorax.

• Perform surgical procedures to achieve hemostasis.

• Administer advanced fluid resuscitation, including blood transfusion.
• Administer sedative, analgesic and paralytic medications.
• Initiate invasive and non-invasive vital sign monitoring to include: arterial oxygen saturation, quantitative measurement of expired end-tidal carbon dioxide, measurement of core body temperature, arterial pressure, and central venous pressure.
• Insert gastric and urinary bladder drainage catheters.
• Administer vasoactive medications to support blood pressure and maintain organ blood flow.
• Administer medications and institute measures to reduce brain swelling and lower intracranial pressure.
• Administer treatments and medications to patients with crush injury in order to reduce the risk of myoglobin-induced acute renal failure.
• Perform life-saving extremity amputation.
• Provide advanced medical and triage expertise for mass-casualty incidents, including incidents potentially involving weapons of mass destruction.

The Trauma Center also remains available to develop individualized disaster or tactical response plans for regional EMS agencies or jurisdictions having specialized medical or rescue needs. For more information, please contact the EMS Coordinator Office at 410-328-2701 or 800-528-1732.

EMS Clinicians: For all patient feedback, please call 410-328-8844.