Analysis of ‘Code red trauma calls’ promoting the development of a novel cognitive aide for blood product resuscitation.

Background: The management of patients involved in complex trauma follows the principles of Damage Control Resuscitation; of which haemostatic resuscitation is a key pillar to this paradigm. A Code Red Trauma (CRT) Policy enables pre-hospital clinicians and hospital trauma team leaders to deliver blood and blood products to patients at the earliest opportunity upon their arrival to hospital.

Method/ Materials: The conduct of CRT practice over a 6-month period, in a busy MTC, located in the North West of England, was retrospectively examined to assess validity of CRT activation, blood product availability and blood product wastage.

Results: Between 1 January 2017 and 30 June 2017 there were 77 Code Red activations. Approximately two-fifths of activations were attributable to penetrating trauma (32/77), with activity spread throughout a 24-hour period. Subsequent retrospective analysis concluded that only 33 cases (42.9%) actually met the criteria to be “Code Red” and warrant a declaration of a CRT with only 10 of these attributable to penetrating trauma. In total 43 units of blood products were wasted.

Conclusion: To address issues of excessive CRT activation and blood product wastage, we have increased engagement with our regional pre-hospital care services and developed cognitive aide models to assist our trauma team leader’s critical decisions for blood product resuscitation.