1421 The Scottish Code Red Audit report for the period 1st January 2018 to 31st December 2019 with comparison to previous audit findings of Scottish Code Red practice since 1 June 2013

Aims, Objectives and Background The Scottish Transfusion Laboratory Support in Trauma Group (TLSTG) have previously audited National Code Red activations to optimise the transfusion support given patients following major trauma Scotland. This report is for all Scotland whom a was activated between 1st January 2018 31st December 2019 also compares findings previous audits since 1 June 2013. Method Design A clinical lead each centre entered anonymised data onto secure electronic database (REDCap). Abstract 1421 Table Summary comparison 2013-31 Oct 2015 Nov 2015-31 Dec 2017 Jan 2018- 31 Activations 56 66 96 Mean age 43 45 Male % 75 88 69 ISS 26 28 Blunt 74 Received blood products 89 93 90 Pre-hospital transfusions, n 16 48 73 999 activation, mins 70 37 80 tranexamic acid, 78 Volume of clear fluid given, mls 500 285 266 Emergency Department ED arrival SBP, mmHg 104 102 CRC transfusion, 9 4 FFP 50 FBC order result, 81 46 Clotting screen 119 53 14 Use ROTEM / TEG ED, 0 12 13 100 198 Massive n(%) 7 (13) 5 (8) 24 (25) Survival hospital discharge 63 65 activation 33 20 units/ patient first hours Platelet 2 Total wasted CRC, FFP, platelets, 6 Results Conclusion There were activations. (SD 18) years, (69%) male. Median 29 (IQR 19–41, n=76, mean 31, SD 17) with 71 (74%) blunt trauma. 87 (90%) received components (76%) receiving pre-hospital transfusion. 67 (92%) who further time from call 56–106, n=47) minutes 77 (93%, n=93) TXA. after 0–17, n=50) Concentrated Cells (CRC) 5–28, n=49) Fresh Frozen Plasma (FFP). Full Blood Count (FBC) result 50–109, n=61) clotting 54–100, n=83). (68%) survived discharge. increased over audit periods (audit 1=56, 2=66, 3=96), an female% noted this audit. Injury Severity Score (ISS) has (26,28,31) as transfusions (16,48,73), acid% (70,78,93), Rotational Thromboelastometry use (0,12,13) massive (7,5,24). Time FBC, results are maintained or improved. (16,9,17 units) (37 vs wastage increased. Survival% (63,66, 65)