Pothiawala Sohil, Bhagvan Savitha, MacCormick Andrew
Emergency Medicine, Woodlands Health, Singapore 737628, Singapore.
Trauma and Emergency Services, Auckland City Hospital, Auckland 1023, New Zealand.
World J Crit Care Med. 2025 Mar 9;14(1):98487. doi: 10.5492/wjccm.v14.i1.98487.
The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control, and it requires co-ordinated multidisciplinary care. During initial resuscitation of a patient in the emergency department (ED), Code Crimson activation facilitates rapid decision-making by multi-disciplinary specialists for definitive haemorrhage control in operating theatre (OT) and/or interventional radiology (IR) suite. Once this decision has been made, there may still be various factors that lead to delay in transporting the patient from ED to OT/IR. Red Blanket protocol identifies and addresses these factors and processes which cause delay, and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT, while minimizing delay in resuscitation during the transfer. The two processes, Code Crimson and Red Blanket, complement each other. It would be ideal to merge the two processes into a single protocol rather than having two separate workflows. Introducing these quality improvement strategies and coordinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.
对于因大出血而遭受严重创伤的患者,实现确定性出血控制对其护理至关重要,且需要多学科协调护理。在急诊科(ED)对患者进行初始复苏期间,“深红色代码”激活有助于多学科专家迅速做出决策,以便在手术室(OT)和/或介入放射科(IR)套房进行确定性出血控制。一旦做出这一决定,仍可能存在各种因素导致患者从ED转运至OT/IR延迟。“红色毛毯协议”识别并解决这些导致延迟的因素和流程,旨在促进血流动力学不稳定的患者从ED快速安全地转运至OT,同时尽量减少转运期间复苏的延迟。“深红色代码”和“红色毛毯”这两个流程相辅相成。将这两个流程合并为一个协议而非有两个单独的工作流程会是理想的做法。在医院/医疗保健系统的创伤框架内引入这些质量改进策略和协调流程,将有助于进一步改善对需要快速和确定性出血控制的复杂创伤患者的多学科护理。