ABSTRACT
Objectives
To describe the results of a systematic, rapid, and effective method of communication for the definitive treatment of patients with severe traumatic bleeding.
Materials and methods
The Red Wave was developed to improve communication between the emergency department and other strategical processes and to reduce the time from the arrival of severe traumatic hemorrhagic patient to a definitive treatment in the operating room.
On admission, the traumatized patient is seen by the nursing staff in the Red Room, who trigger a general bell indicating the arrival of a severe trauma patient.
The surgeon activates the red bell, which triggers an audible and visual alarm at strategic sectors of the hospital: operating center, transfusional agency, and laboratory, each one with its established sub-protocol. We defined as goals that the patient must arrive at the operating room in a maximum of 15 minutes after the Red Wave activation, with availability of blood and plasma in 20 minutes and blood tests collected at the same time. A light panel located in the surgical center turns off at each completed step, recording their time-responses.
Results
From June through December 2015, we admitted 831 trauma patients in the Red Room of Hospital do Suburbio, predominantly young (67.9% younger than 40 years old) and male (77.5%). Blunt trauma was the predominant mechanism (79.2%), and the majority of patients had an revised trauma score (RTS) calculated at admission greater than 7 (86.5%).
We also evaluated, from September through December 2015, the attendance of 96 patients admitted with a diagnosis of hemorrhagic traumatic shock. The Red Wave was triggered in 39.6% of these cases. Gunshot wounds were the most frequent mechanism of trauma (86.5%), with a survival rate of 56.8%.
The goals for time-responses were met in most of the cases, with correctness of 81.6% for the patient arrival at the operating room, 81.6% for laboratory sampling, and 86.8% for blood and plasma availability by the transfusion agency.
Conclusion
The Red Wave proved to be an effective protocol to systematize the initial treatment of patients with severe traumatic bleeding, improving communication between the strategic sectors involved, reducing the time-response of each service and making the definitive treatment of these patients faster and suitable.
How to cite this article
Romeo AC, Cunha AG, Filho PS, Oliveira V, Moura T, Motta J, Mendes G, Cruz MR. Red Wave: Improving Care to Severe Trauma Victims. Panam J Trauma Crit Care Emerg Surg 2017;6(3):155-159.
Recovery of functional capacity in severe trauma victims at one year after injury: association with trauma-related and hospital stay aspects