Role Clarity in Activated Traumas: Why Pharmacy Support Must Know Its Lines Before the Curtain Rises
When the trauma pager goes off, the emergency department instantly transforms into something resembling a high‑stakes Broadway production—except the stakes are real, no one gets a dress rehearsal, and the script changes every 12 seconds. In the middle of this controlled chaos stands a multidisciplinary team, each member with a crucial part to play. But among them, the pharmacy support team often gets the most ambiguous stage directions. The solution? Role clarity—the difference between seamless trauma care and a medication‑related plot twist no one wanted.
Why Role Clarity Matters in Activated Traumas
Activated trauma resuscitations demand rapid, well‑coordinated clinical decisions. Pharmacy professionals—pharmacists, technicians, and support staff—play a critical role in ensuring medication accuracy, safety, and timeliness. Yet the lack of clearly defined roles in trauma settings has long been identified as a barrier to optimal performance and patient outcomes. Scoping reviews show that responsibilities among trauma pharmacists vary widely, making it challenging to measure performance or establish consistent expectations (Gessner et al., 2023).
Compounding this, an estimated one in five Level I and II trauma centers in the United States incorporate pharmacy services directly into trauma resuscitations—meaning role inconsistency leaves room for dangerous variation in practice (Costello & Leng, 2010).
The Pharmacy Team’s Contributions During Trauma Activation
1. Medication Expertise at the Speed of Trauma
Trauma patients require rapid administration of medications ranging from paralytics and sedatives for intubation to hyperosmolar therapies for traumatic brain injury. Pharmacists in trauma settings provide real‑time medication guidance, verify dosing, anticipate needs, and prepare drugs during time‑sensitive interventions (DeSio, 2022). Without a defined role, these tasks risk duplication or omission—a problem rarely appreciated until the wrong medication arrives on the bedside tray.
2. Improving Safety Through Clinical Consistency
Trauma care is inherently high‑risk, and medication-related errors can be catastrophic. Studies highlight how clinical pharmacists help ensure safe and effective medication use during trauma resuscitations and complex critical‑care transitions (Costello & Leng, 2010). Role clarity ensures that pharmacists and support personnel integrate smoothly into trauma workflows rather than becoming last‑minute add‑ons.
3. Support Personnel: The Unsung Heroes Needing Clear Expectations
Pharmacy technicians and support staff are vital in maintaining inventory, preparing medications, ensuring availability of trauma carts, and assisting pharmacists with urgent tasks. However, research repeatedly notes that their duties vary significantly between institutions and settings (Borchert et al., 2019). In high‑acuity trauma settings, ambiguity about who retrieves medications, who prepares them, and who communicates updates can derail the team’s rhythm faster than a misplaced scalpel.
Where Role Clarity Falls Short
Trauma scenes are hectic—and ambiguity fuels inefficiency. Without standardized expectations, the pharmacy team may unintentionally repeat tasks, miscommunicate medication plans, or delay critical interventions. Scoping reviews lament the heterogeneity of trauma pharmacist involvement and call for clearer definitions aligned with evidence‑based performance indicators such as cpKPIs (Gessner et al., 2023).
Additionally, trauma‑informed care principles remind us that patients and families often arrive in a state of extreme vulnerability, fear, or confusion. These principles should guide how pharmacy personnel communicate and collaborate during crisis moments—but again, role clarity is essential for consistent implementation (MacKenzie & Hill, 2025).
Building Role Clarity: A Prescription for Success
A successful activated trauma response requires every member of the pharmacy team to know exactly what to do, when to do it, and how to communicate it. Based on the current literature:
1. Establish Clear Competency‑Based Role Definitions
Align pharmacist and technician responsibilities with trauma‑specific competencies and evidence‑based practice indicators (Gessner et al., 2023).
2. Standardize Expectations Across the Trauma Continuum
From emergency department activation to ICU admission and beyond, pharmacists serve different functions—medication preparation, dosing guidance, monitoring, and post‑resuscitation optimization (Santiago et al., 2025).
3. Integrate Pharmacy Support Into Trauma‑Team Training
Just as surgeons, nurses, and respiratory therapists train together, pharmacy support should be embedded into simulations to reinforce when and how they contribute during activation.
4. Document Workflows—Then Communicate Them Widely
A policy stored in a binder no one uses is as helpful as a naloxone vial sealed inside a display case—technically available, practically useless.
Conclusion
In activated traumas, pharmacy support professionals are essential—but only when their roles are clear, coordinated, and consistently practiced. Role clarity ensures the team performs not like improvisational artists but like a skilled ensemble executing a well‑rehearsed performance. After all, trauma care isn’t the place for guesswork. It’s where precision saves lives—and where pharmacy support, when empowered with clarity, becomes indispensable.
As trauma care continues to grow in complexity, pharmacy support teams can no longer operate in the gray zones of assumption and improvisation. It’s time to turn clarity into standard practice. If you are a healthcare leader, pharmacist, technician, or trauma‑team member, take the next step today:
Define and document pharmacy roles within activated trauma workflows.
Integrate pharmacy support into trauma simulations to reinforce expectations under real‑world pressure.
Empower technicians and pharmacists with trauma‑specific training and competency frameworks.
Promote trauma‑informed communication across the entire team to support both patient and staff wellbeing.
When pharmacy roles are clear, outcomes improve, teamwork strengthens, and patient care becomes not only safer—but truly exceptional. Let’s commit to building trauma systems where every pharmacy professional knows their role, owns it, and performs it with confidence when seconds matter most.
References
Borchert, J. S., Phillips, J., Thompson, M. L., Livingood, A., Andersen, R., …Lee, J. C. (2019). Best practices: Incorporating pharmacy technicians and other support personnel into the clinical pharmacist’s process of care. Journal of the American College of Clinical Pharmacology, 2(1) 74-81. https://doi.org/10.1002/jac5.1029
Costello, J., & Leng, W. (2010). The pharmacist’s role on the trauma team. The Journal of Lancaster General Hospital. 5(4), 117-119. https://www.jlgh.org/JLGH/media/Journal-LGH-Media-Library/Past%20Issues/Volume%205%20-%20Issue%204/costello54.pdf
DeSio, A. (2022). Trauma in critical care: The pharmacist’s role. https://www.ichpnet.org/events/spring_meeting/2022/ce/033_-DeSio_Andrew-Trauma_in_Critical_Care-_1_up.pdf
Gessner, B., et al. (2023). The role of the clinical pharmacist in the care of trauma patients: A scoping review (Poster Presentation). https://static1.1.sqspcdn.com/static/f/920943/28596830/1685735153613/GESSNER+Brooke+PosterMay15.pdf
MacKenzie, A., & Hill, A. (2025.). How to improve pharmacy services by integrating trauma‑informed care. The Pharmaceutical Journal. https://pharmaceutical-journal.com/article/ld/how-to-improve-pharmacy-services-by-integrating-trauma-informed-care
Santiago, R., Gilbert, B., Ray, L., & Reichert, E. (2025). Pharmacotherapy of trauma and the role of the pharmacist. In Y. Alzaidi & M. A. Gebily (Eds.), The pharmacist’s expanded role in critical care medicine (pp. 1063–1118). Springer Nature. https://doi.org/10.1007/978-3-031-77335-8_41
