Transfusion and Laboratory support in Trauma Group Code Red Audit
The aim of the Code Red audit is to monitor and optimise the transfusion support given to patients following major trauma in Scotland
The primary objective is to optimise the transfusion support given to patients following major trauma in Scotland, including the delivery of laboratory services and transfusion support in both the pre-hospital and hospital setting along with the introduction of novel services and approaches.
A standardised data collection form (DCF) was designed and agreed by the Transfusion and Laboratory Support in Trauma Group (TLSTG). Page one of the DCF contains patient information and a unique national code red audit number. Pages 2-4 of the DCF contain anonymised data which will be sent to Alison Glover to enter onto a secure database. Once piloting, this anonymised data will be entered directly onto a web based database (REDcap).
Ethics opinion was obtained from the Lothian Regional Ethics Committee Scientific Advisor and the project was deemed a service evaluation/audit and not therefore requiring full ethics submission. The Caldicott guardian for NHS Lothian has approved the use of the REDcap secure database. Funding for use of the REDcap database was secured from SNBTS
All data is owned by the NHS. Matthew Reed and Alison Glover will maintain the database and act as guardians for the data. The project will initially last 2 years until 30th September 2016 however it is anticipated that the project will be an ongoing one. Data collection is currently underway including retrospective data collection from the introduction of the Code Red protocol at each participating hospital.
Scotland’s main trauma receiving hospitals have agreed to input data into the National Code Red audit and a clinical and transfusion lead has been identified for each centre.
Matthew Reed,Research Team – Members of the Transfusion and Laboratory support in Trauma Group
Scotland’s main trauma receiving hospitals have agreed to input data into the National Code Red audit
Early diagnosis is central to improving outcomes for patients with cancer. For cancers without specific risk factors, or with no screening programs are difficult to diagnose and patients often present with non-specific symptoms. Unfortunately this means that these patients are often diagnosed late on in the development of the disease and treatment options are reduced.
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.