The highest mortality rate of major trauma patients in emergency department (ED) is due to the rapid progression in nature, which needs trauma resuscitation management immediately and efficiently. The members of “trauma team” among major hospitals, which usually includes surgeons, surgical nurses, and nursing leaders, are responsible for assessment and necessary emergency treatment for major trauma patients. The “trauma team” also called “Trauma Blue”, is usually activated by triage nurses. The authors found that, there were 165 unnecessary or misjudged “Trauma Blue” activated by triage in 2008. The integrity of the major trauma treatment process was only 76.67%, dramatically impacting the correctness and effectiveness in management of major trauma patients. In order to provide prompt and comprehensive care for major trauma patients in ED, the purpose of the project was to improve the correctness of the activation process and the protocol integrity of the “trauma team”. Through the decision analysis process, the resolutions include in-service education and periodically evaluation, improvement of activation of electronic system, pre-assigned surgical staffs as members of the “trauma team” each shift, and protocol establishment. After the strategies described as above, the knowledge of correctly activating the “trauma team” improved from 68.51 point to 92.10, a 23.59% increase. The frequency of abnormal “trauma team” activation decreased from 16.82% in 2008 to 9.93% from April 30, 2009 to May 1, 2010. The protocol integrity after the “trauma team” activation raised from 76.67% to 92.83%. The outcomes of this project may provide the information regarding how to handle and enhance immediate care effectively for major trauma patients in ED.