Massive blood loss protocol ‘Code Red’ at Papworth Hospital: A closed loop audit

Massive blood loss protocol ‘Code Red’ at Papworth Hospital: A closed loop audit

Aim To investigate if the massive blood loss protocol ‘Code Red’ at a specialist cardiothoracic hospital was activated according to local and national guidelines by a closed loop audit. Methods Electronic and paper patient care systems were searched in 2015 and 2018 to access records for the ‘Code R...

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Bibliographic Details
Published in:Journal of perioperative practice Vol. 31; no. 9; pp. 334 - 340
Main Authors: Tennyson, M, Redlaff, J, Biosse-Duplan, G, Lewin, M, Jones, N, Layard Horsfall, H
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-09-2021
Association for Perioperative Practice
Subjects:
Adult
Audits
Blood Transfusion
Closed loop systems
Emergency medical care
Hematology
Hemorrhage
Hospitals
Humans
Intensive care
Original
Protocol
Quality control
Quality improvement
Retrospective Studies
Audit
Intensive care
Quality improvement
Transfusion
Massive haemorrhage
Cardiothoracic
Haemorrhage protocol transfusion
Cardiothoracics
Massive blood loss
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Summary:Aim To investigate if the massive blood loss protocol ‘Code Red’ at a specialist cardiothoracic hospital was activated according to local and national guidelines by a closed loop audit. Methods Electronic and paper patient care systems were searched in 2015 and 2018 to access records for the ‘Code Red’ activations. Activation of the massive blood loss protocol was compared against the national standards set by The British Committee for Standards in Haematology. The percentage of cases meeting each of the ten standards in the specialist cardiac unit’s Protocol for the Management of Massive Blood Loss in Adults (adapted from the national standards) were evaluated. Results ‘Code Red’ protocol was activated on 18 occasions in 2015 and nine occasions in 2018, representing just 0.83 and 0.26% of emergency surgeries, respectively. Between 2015 and 2018, there was a 6% increase of ‘Code Red’ cases being appropriately activated, a 26% increase in the prompt notification of the haematology department upon activation, alongside a 30% increase in the timely delivery of blood products, and a 25% decrease in the average amount of blood transferred prior to ‘Code Red’ activation. Conclusion There has been an improvement in the standards of care and management of massive blood loss this specialist cardiac centre despite the target timeframe being reduced from 30 to 15min between 2015 and 2018. Preparation for and anticipation of massive blood loss has likely decreased the number of incidences requiring ‘Code Red’ activation, permitting delivery of safe patient care.
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ISSN:1750-4589
2515-7949
DOI:10.1177/1750458920943361