The Development of a Trauma Interventional Radiology Alert Protocol Reduces Time to Vessel Puncture in Cases of Active Hemorrhage.

Introduction Trauma continues to be a major cause of death in the United States, with uncontrolled bleeding contributing to a significant portion of trauma-related fatalities. In recent years, the management of hemorrhagic trauma patients has expanded to include interventional radiology (IR). The American College of Surgeons Committee on Trauma recommends that Level 1 and 2 trauma centers ensure IR availability within 60 minutes of the decision to proceed with angiography. Delays in IR intervention are associated with poorer outcomes and increased mortality. To address this, our Level 2 trauma center developed and implemented an institutional protocol involving trauma surgeons, interventional radiologists, residents, trauma advanced practice providers, ED staff, and IR nursing teams to reduce time to intervention for trauma patients with uncontrolled hemorrhage. Methods On March 1, 2023, a new institutional protocol was launched to expedite IR intervention in trauma patients with hemorrhage. When such a patient is identified, the trauma team leader (TTL) directly contacts an IR physician to review imaging and determine the need for urgent endovascular therapy. If IR intervention is agreed upon, the TTL places a STAT IR consult, which marks the start time for time tracking. This time period ends when an IR physician achieves vascular access. To accelerate intervention, the TTL informs the primary nurse of the protocol activation, and a trauma vascular IR (VIR) alert is sent via Vocera