Massive blood loss protocol 'Code Red' at Papworth Hospital: A closed loop audit.
M Tennyson, J Redlaff, G Biosse-Duplan and 3 others
PMID 32895000WHAT IT FOUND
Code Red was activated in line with protocol 89% of the time, and blood products arrived faster.
Mortality could not be compared, so this shows process improvement, not better patient outcomes.
Key findings
01Code Red was activated in line with protocol 89% of the time on re-audit, an improvement of 6%.
02Timely receipt of blood products after activation increased by 30%, and in 2018 products were received in under 10 minutes in 56% of cases.
03The average amount of blood transfused before activation reduced from 10.1 units to 7.6 units, while use of the minimum required number of blood products decreased by 66.6%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample was very small, with 18 patients in 2015 and 9 patients in 2018, and the authors state this prevents definitive conclusions about mortality. Six activations in 2015 were excluded because documentation was missing, so the first audit cycle may not represent all activations. The comparison of 2015 and 2018 was retrospective, and there were no prospective data collection points or functional outcomes. The audit reports process standards, not a controlled test of whether Code Red improves patient recovery.
The easy way to misread this
Do not read the 89% activation rate or faster product delivery as proof that Code Red reduced death or improved patient outcomes. The audit was small and retrospective, and the authors state it cannot draw definitive conclusions about mortality.