None listed
Conditions
Brief summary
The purpose of this study is to join these two data sources (prehospital data from NSW State Wide Retrieval Database (SWRD) and Careflight’s retrieval database with in-hospital data from the NSW Trauma database). This will allow us to describe in better detail the patient population in whom a trauma ‘prehospital Code Crimson’ pathway was activated, the rate of requirement for continued in-hospital transfusion of blood products, the need for and timing of early interventions to control haemorrhage following hospital arrival, and the coagulation profile of these patients. It will also aim to review the accuracy of prehospital physicians in determining whether or not their haemodynamically unstable patients will require either ongoing transfusion or interventional haemorrhage control.
Interventions
In New South Wales, The Institute of Trauma and Injury Management (ITIM) Trauma ‘Prehospital Code Crimson’ protocol was implemented in October 2017. Activation of this protocol is indicated in patients with ‘persistent haemodynamic instability despite standard trauma care, assessed as being secondary to ongoing haemorrhage in blunt or penetrating trauma, which is unresponsive to intravenous fluids and or blood transfusion’. The current protocol involves activation by a prehospital physician whic
In New South Wales, The Institute of Trauma and Injury Management (ITIM) Trauma ‘Prehospital Code Crimson’ protocol was implemented in October 2017. Activation of this protocol is indicated in patients with ‘persistent haemodynamic instability despite standard trauma care, assessed as being secondary to ongoing haemorrhage in blunt or penetrating trauma, which is unresponsive to intravenous fluids and or blood transfusion’. The current protocol involves activation by a prehospital physician which results in both the mobilisation of in-hospital resources including massive transfusion protocol and operating theatre preparation. It also triggers notification to specific interventionalists such as the trauma surgeon and other relevant specialist surgeons as well as the interventional radiologist. This is designed to facilitate a rapid decision, within ten minutes of a patient’s arrival to hospital, as to whether an immediate interventional or operative is needed. This study is purely a passive observational one and as such does not involve any additional investigation/testing/interviews on top of routine medical care. Each participants will be observed from the initiation of their prehospital care (point of injury) through to discharge from hospital.
Sponsors
NSW Ambulance (Aeromedical Operations)
Eligibility
Sex/Gender
All
Healthy volunteers
No
Inclusion criteria
1. Trauma patients retrieved by Aeromedical operations across the Greater Sydney Area (Bankstown, Wollongong, Orange or Careflight bases) who triggered a prehospital code crimson activation 2. Trauma patients who are identified by the ITIM Trauma Registry as either prehospital Code Crimson activation/Massive Transfusion Protocol (MTP), or have a CT scan within one hour or procedure (see Table 2 in the attached study protocol) within 6 hours or who die in the emergency department
Exclusion criteria
NSW Trauma Registry patients who do not meet the criteria of a prehospital code crimson response
Outcome results
None listed