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Nurse 1 > Code Red > Flashcards

Code Red Flashcards

1
Q

When must a trauma team leader declare a code red?

A

Systolic below 90
Poor response to initial fluid resus
Suspected active haemorrhage

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2
Q

What is contained in a code red pack A?

A

4 units RBC
4 units FFP

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3
Q

What is contained in a code red pack B?

A

6 units RBC
6 units FFP
2 cryo
1 pool platelets

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4
Q

When would you request or use a pack B?

A

If the patient is still bleeding

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5
Q

What blood type do you use for a female patient?

A

O neg

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6
Q

What type of blood do you use for a male patient?

A

O pos

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7
Q

What is essential for all blood products?

A

Traceability

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8
Q

Who must you inform when units are used from the resus fridge?

A

Blood bank so that stocks can be replaced

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9
Q

When should you switch from Group O to a patients blood type?

A

As soon as the cross match result is available

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10
Q

What type of blood do you use for a paediatric patient?

A

O neg

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11
Q

What blood level do you need to check after 6 units of RBC?

A

Calcium

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12
Q

What drug do you need to check has been given by Hems?

A

TXA

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13
Q

Who can declare a Code Red?

A

A pre hospital doctor (Hems)
Advanced paramedic practitioner (APP)
Consultant in charge

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14
Q

How do you prepare a bay for a Code Red?

A

Trauma of pack ordered
Bloods and CT ordered
Computer in bay
Trolley
Theatre lights turned on
2 name bands
Bear hugger available
Monitoring ready
Belmont primed
Ultrasound machine
Anaesthetic equipment
Arterial pressure transducer primed
IV access and venapuncture equipments
Sterile procedures preparation
Transfer kit available

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15
Q

What drugs may you require for a Code Red?

A

Anaesthetic drugs tray from fridge
Ketamine
Fentanyl
Propofol (big one)
TXA
Calcium chloride 10ml 10% (Hypocalcaemia and hyperkalaemia)
Act rapid and 50ml 50% dextrose (hyperkalaemia)

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16
Q

What is the ROTEM analyser used for?

A

To confirm or exclude Acute Traumatic Coagulopathy (ATC) in under 5 mins

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17
Q

How can normothermia be maintained in Code Red patients?

A

Keep patient covered up
Use Bear Hugger
Trauma mattress
Give blood units through Belmont

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18
Q

Who should the Nurse 1 notify if the Code Red patient moves to theatres or IR?

A

The transfusion lab

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19
Q

What should Code Red patients have requested prior to leaving for theatre or IR?

A

Pack B

20
Q

What is Octaplex used for?

A

Reversal of warfarinised patients and other DOACs

21
Q

Where is Octaplex stored?

A

Code Red cupboard

22
Q

What speciality needs to be discussed with before Olaplex is given to a patient?

A

Haematology

23
Q

How much Octaplex should be stocked in resus at any one time?

A

3,000 units

24
Q

What can you find on the top shelf of the code red cupboard?

A

Adult pelvic splint
Blast bandage
Israeli bandage
Celox gauze
Tourniquet- CAT

25
Q

What can you find on the middle shelf of the code red cupboard?

A

Coagucheck XS machine - fully charged
Test strip bottle
Lancets
Surgical airway kit - sealed
Tuff cut shears

26
Q

What can you find on the bottom shelf of the code red cupboard?

A

Dental props - S,M,L
Epistats

27
Q

What would you find in the small cupboard inside the code red cupboard?

A

TXA
Octaplex
Dosing sheet
Administration aide memoire
Octaplex administration sheet

28
Q

Where do you find the priority card for the lift?

A

Door of code red cupboard

29
Q

What is TXA?

A

An anti-fibrinolytic agent that helps to prevent haemorrhage

30
Q

What is damage control surgery?

A

Surgery involving using limited surgical interventions to control haemorrhage and minimise contamination until the patient has sufficient physiological reserve to undergo definitive interventions. Survival is given precedence over morality

31
Q

What are the ideal blood component ratios?

A

1 PRBC: 1 FFP : 1 Platelets

32
Q

What is the aim of damage control resuscitation?

A

Maintain circulating volume, control haemorrhage and correct the triad of death

33
Q

What is damage control resuscitation?

A

A systemic approach to the management of trauma patients with sever injuries. It starts in ED and carries through to theatres and ITU

34
Q

What are the 5 sites of major trauma?

A

Chest
Abdo
Pelvis
Long bones
External e.g scalp

35
Q

As nurse 1 in resus, how would you prepare for a code red?

A

Put out 2222
Ensure trauma team complete
Assign a primary and Belmont nurse
Call for a trauma pack
Call transfusion and request pack A and or B as per discussion with TTL
Ensure Belmont primed
Wristbands and bloods
Listen to handover when patient arrives

36
Q

Where do you put the blood labels for used units?

A

In slot under blood fridge

37
Q

Why do we use invasive pressure monitoring?

A

Allows continuous accurate blood pressure monitoring for critically unwell patients
Allows frequent ABG samples

38
Q

What equipment will you need once an ART line has been placed?

A

Transducer cable - single
Pressure bag
500ml saline
Art line giving set primed

39
Q

How do you zero an ART line?

A

Stop cock close to patient and open to air
Press zero on monitor

40
Q

What is the aim of
haemostatic resuscitation?

A

To resuscitate the patient with blood component ratios resembling whole blood, therefore, avoiding acute traumatic coagulopathy with the aim to maintain circulating volume, limit ongoing bleeding and prevent/reverse the triad of death

41
Q

What does damage control resuscitation involve?

A

Haemostatic resuscitation, permissive
hypotension and damage control surgery

42
Q

What can cause acidosis to worsen in a trauma patient?

A

Administration of large volumes of crystalloids

43
Q

How is acidosis defined?

A

Arterial pH of less than 7.35 and in trauma is likely secondary to poor tissue perfusion

44
Q

What does the triad of death lead to?

A

Worsening haemorrhage and eventually death

45
Q

What is the triad of death?

A

Hypothermia, acidosis and coagulopathy

46
Q

When does acute traumatic coagulopathy occur?

A

Immediately after massive trauma when shock, hypoperfusion and vascular damage are present

Nurse 1 (24 decks)

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