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 | ☐ | ☐ | ☐ | ||