Expanding the trauma code to other causes of hemorrhagic shock — ruptured abdominal aortic aneurysms

Summary: Expediting life-saving care for hemorrhagic shock through multi-disciplinary code protocols is a potential method to improve outcomes. Trauma codes have become standard of care at most tertiary care centres; however, it is unclear if similar protocols can improve delivery of care for other forms of hemorrhagic shock. We examined the feasibility of a code protocol for ruptured abdominal aortic aneurysms (RAAAs) by reviewing the literature and comparing patient outcomes for RAAA and trauma patients at our institution, where the latter have a wellestablished trauma code protocol. We show that, despite being similarly unstable, patients with RAAA experienced delays to care milestones compared with trauma patients, even when accounting for diagnostic delays. Combining these data with present understanding of factors implicated in RAAA survival, we propose that a “CodeAAA” protocol may fill an important gap in RAAA care and that further prospective studies examining the utility of such a code are warranted.