Table 4 Treatment pathway checklist
Treatment phase | Yes | No | N/A | Reason for variance | |
|---|---|---|---|---|---|
Initial assessment and management | |||||
Extent of traumatic haemorrhage assessed | ☐ | ☐ | ☐ | ||
Patient in shock with identified source of bleeding treated immediately | ☐ | ☐ | ☐ | ||
Patient in shock with unidentified source of bleeding sent for further investigation | ☐ | ☐ | ☐ | ||
Coagulation, haematocrit, serum lactate, base deficit assessed | ☐ | ☐ | ☐ | ||
Antifibrinolytic therapy initiated | ☐ | ☐ | ☐ | ||
Patient history of anticoagulant therapy assessed (vitamin K antagonists, antiplatelet agents, oral anticoagulants) | ☐ | ☐ | ☐ | ||
Resuscitation | |||||
Systolic blood pressure of 80–90 mmHg achieved in absence of traumatic brain injury | ☐ | ☐ | ☐ | ||
Measures to achieve normothermia implemented | ☐ | ☐ | ☐ | ||
Target haemoglobin level 7–9 g/dl achieved | ☐ | ☐ | ☐ | ||
Surgical intervention | |||||
Abdominal bleeding control achieved | ☐ | ☐ | ☐ | ||
Pelvic ring closed and stabilised | ☐ | ☐ | ☐ | ||
Peritoneal packing, angiographic embolisation or surgical bleeding control completed in haemodynamically unstable patient | ☐ | ☐ | ☐ | ||
Damage control surgery performed in haemodynamically unstable patient | ☐ | ☐ | ☐ | ||
Local haemostatic measures applied | ☐ | ☐ | ☐ | ||
Thromboprophylactic therapy recommended | ☐ | ☐ | ☐ | ||
Coagulation management | |||||
Coagulation, haematocrit, serum lactate, base deficit, calcium reassessed | ☐ | ☐ | ☐ | ||
Target fibrinogen level 1.5–2 g/l achieved | ☐ | ☐ | ☐ | ||
Target platelet level achieved | ☐ | ☐ | ☐ | ||
Prothrombin complex concentrate administered if indicated due to vitamin K antagonist, oral anticoagulant or evidence from viscoelastic monitoring | ☐ | ☐ | ☐ | ||