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Related Experiment Video

Updated: Dec 9, 2025

Generation and Culture of Blood Outgrowth Endothelial Cells from Human Peripheral Blood
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Massive blood loss protocol 'Code Red' at Papworth Hospital: A closed loop audit.

M Tennyson1, J Redlaff2, G Biosse-Duplan2

  • 1Addenbrooke's Hospital, Cambridge, UK.

Journal of Perioperative Practice
|September 8, 2020
PubMed
Summary

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The "Code Red" massive blood loss protocol in cardiothoracic surgery showed improved adherence to guidelines between 2015 and 2018. Enhanced preparation and timely blood product delivery contributed to safer patient care.

Area of Science:

  • Cardiothoracic Surgery
  • Hematology
  • Patient Safety

Background:

  • Massive blood loss (MBL) is a critical complication in cardiothoracic surgery.
  • The 'Code Red' protocol was implemented to manage MBL according to established guidelines.
  • A closed-loop audit was performed to assess protocol adherence and patient outcomes.

Purpose of the Study:

  • To evaluate the adherence of the 'Code Red' MBL protocol to local and national guidelines.
  • To assess the impact of protocol implementation on patient care and outcomes.
  • To identify areas for improvement in MBL management within a specialist cardiothoracic hospital.

Main Methods:

  • Retrospective audit of electronic and paper patient records from 2015 and 2018.
  • Comparison of 'Code Red' activations against national standards from The British Committee for Standards in Haematology.
Keywords:
AuditCardiothoracicCardiothoracicsHaemorrhage protocol transfusionIntensive careMassive blood lossMassive haemorrhageQuality improvementTransfusion

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  • Evaluation of adherence to ten key standards in the hospital's MBL protocol.

    • Main Results:

    • 'Code Red' activations decreased from 0.83% in 2015 to 0.26% in 2018.
    • Significant improvements observed: 6% increase in appropriate activations, 26% increase in prompt hematology notification, 30% increase in timely blood product delivery.
    • A 25% decrease in pre-activation blood transfusions was noted.

    Conclusions:

    • The 'Code Red' protocol demonstrated improved adherence to MBL management standards.
    • Enhanced preparation and anticipation of MBL likely reduced protocol activations, ensuring safe patient care.
    • Improvements were noted despite a reduced activation timeframe, indicating effective protocol refinement.