TY - JOUR T1 - 042 Scottish code red audit report 2015–2017 JF - Emergency Medicine Journal JO - Emerg Med J SP - 802 LP - 805 DO - 10.1136/emermed-2019-RCEM.42 VL - 36 IS - 12 AU - Matt Reed AU - Claire Cooke AU - Niall McMahon AU - Katie Hands AU - Susan Henderson AU - Eleanor Knight AU - Munsor Latif AU - Nicola Littlewood AU - Naomi Todd AU - Margaret McGarvey AU - Neil Hughes AU - Michael Donald AU - Megan Rowley AU - Catherine Innes AU - Symon Lockhart Y1 - 2019/12/01 UR - http://emj.bmj.com/content/36/12/802.abstract N2 - The Scottish Transfusion and Laboratory Support in Trauma (TLST) group previously audited all National Code Red activations between June 1st 2013 and October 31st 2015, generating a number of recommendations to be adopted to optimise the transfusion support given to patients following major trauma in Scotland. A repeat audit was undertaken for all patients for whom a Code Red was activated between 1st November 2015 and 31st December 2017.A clinical and transfusion lead for each centre entered anonymised data onto a secure electronic database (REDCAP; http://www.project-redcap.org) the server of which is held within the University of Edinburgh. This database was maintained by the Edinburgh study team. Each of Scotland’s pre-hospital trauma teams who take patients to hospitals where Code Red Policy is in place, and the receiving hospitals, agreed to enter data into the National Code Red audit for all patients for whom a Code Red was activated during the study period. The project was deemed a service evaluation by the South East Scotland Research Ethics committee (Ref: NR/1408AB11) and therefore did not require full ethics submission. The project was also registered with each hospital’s clinical effectiveness/governance teams where available, and a favourable Caldicott opinion was obtained.Abstract 042 Figure 1 Flow chart showing transfusion events and outcomes of code red patientsAbstract 042 Figure 2 Ratio of the mean number of concentrated red cells (CRC) and fresh frozen plasma (FFP) transfused to code red patients at 30 minute intervalsView this table:Abstract 042 Table 1 66 activations (24 South-East of Scotland, 32 West, 10 East). Mean age 45 years, 88% male patients. 93% of Code Red patients received blood components with a 300% increase in pre-hospital transfusion (48 patients; 73%); median time from 999 call to Code Red activation reduced to 37 minutes from 70 minutes; 78% patients received pre-hospital TXA (improved from 70%). CRC:FFP ratios improved in comparison to 2013–15. Survival to discharge increased (63% to 66%) despite increased ISS.Code Red practice has improved since our last audit. There are still improvements to be made in TXA administration and time to blood products. ER -