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‘Code Red’ Major Trauma Response at Waikato Hospital, New Zealand

Authors List
Christey, G., Te Manawa Taki Trauma System, Te Whatu Ora Waikato & Waikato Clinical School, University of Auckland, Hamilton, New Zealand
Soysa, I., Te Manawa Taki Trauma System, Te Whatu Ora Waikato, Hamilton, New Zealand
Smith, A., Te Manawa Taki Trauma System, Te Whatu Ora Waikato, Hamilton, New Zealand


Introduction

Code Red is and enhanced trauma call process that involves immediate attendance by specific clinical personnel to patients in ED with actual or potentially life-threatening injuries such as exsanguination or intracranial haematoma that need immediate intervention and scaled resource allocation (Curry et al. 2011). Criteria are broad and can be activated by prehospital personnel.

Aims

To address potentially life-threatening injuries and mobilise hospital resources by avoiding delays in treatment in exsanguinating or neurological trauma patients.

Methods

A retrospective review of all Code Red cases presenting to a level one trauma centre from 1 July 2019 to 30 June 2022 to determine the patterns of presentation and the types and timings of interventions was performed.

Results

104 patients underwent Code Red activation over the study period. The rates of Code Red increased from 6.2 to 12.7/100 major trauma admissions (ISS.12) per year between from the first year to the third year. 43% of Code reds occurred following road traffic crash, followed by motorcycle crash (12%) and assault (12%). The median time in ED was 89 minutes. There was a statistically significant decrease in time to Operating Room (OR) to 68 minutes (F 30.7,<0.0001) over the study period. 78% of Code Red patients had an index CT prior to final destination, including 70% of those that went to OR. 25% of patients activated massive transfusion protocol.

Conclusion

There was a significant decrease in time to OR for Code Red patients over the study period. Only 25% of patients had MTP activation. This information will be used to rationalise Code Red criteria and processes.

References

1. Curry, N., Hopewell, S., Dorée, C., Hyde, C., Brohi, K., & Stanworth, S. (2011). The acute management of trauma hemorrhage: a systematic review of randomized controlled trials. Critical care (London, England), 15(2), R92.

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