Rapid Response to Traumatic Vascular Injury: An Institutional Code Angio Protocol

Area of Science:

• Trauma care
• Vascular surgery
• Interventional radiology

Background:

• Traumatic vascular injuries are a leading cause of death and disability, particularly in young adults.
• Vascular and interventional radiology (VIR) offers minimally invasive solutions for these injuries.
• Timely intervention is critical for managing life-threatening hemorrhage.

Purpose of the Study:

• To evaluate the implementation and impact of a Code Angio protocol at a Level I trauma center.
• To assess the protocol's effectiveness in expediting VIR response times for traumatic vascular injuries.
• To analyze the impact on patient outcomes, surgical interventions, and resource utilization.

Main Methods:

• A Code Angio protocol was initiated, using automated alerts to notify a multidisciplinary team (VIR, trauma surgery, anesthesia, OR) for patients meeting vascular injury criteria.
• Data was collected from August 2014 to 2024, analyzing response times, interventions, and patient survival.
• A retrospective analysis of 1,447 cases was performed to assess protocol effectiveness.

Main Results:

• Code Angio implementation led to decreased VIR response times, with most activations occurring within 60 minutes.
• The protocol reduced the need for urgent laparotomies for hemorrhage control.
• Patients managed with Code Angio demonstrated higher survival rates compared to surgery alone.

Conclusions:

• Rapid response protocols like Code Angio significantly improve patient outcomes in traumatic vascular injuries.
• The protocol optimizes resource utilization and enhances healthcare efficiency in trauma centers.
• Continuous refinement and integration with trauma guidelines are essential for further optimization.