Resources for management of critical bleeding

Implementation of the critical bleeding national guidance

These four resources are for staff who manage critically bleeding trauma patients in tertiary trauma centres and smaller secondary or provincial hospitals. They support the implementation of the national best-practice critical bleeding bundle of care with associated guidance and standardise the management of critical bleeding.

A brief description of the purpose of each resource follows, and you can download electronic (editable) and printable versions of the resources at the bottom of this page. Providers are free to edit and add organisation logos to the editable versions.

Critical haemorrhage infrastructure site survey

This site survey audit tool is to help providers complete an annual review of infrastructure and equipment availability for any service that may be required to manage the care of a critically haemorrhaging trauma patient.

Trauma volumes vary widely in different centres in Aotearoa New Zealand, which means not all providers will have the infrastructure to support all the suggested best-practice system changes included in the critical haemorrhage bundle of care. The bundle of care serves as a broad guide, but local systems are encouraged to adapt the bundle to suit their available resources.

Critical haemorrhage clinical audit tool

This tool walks you through the steps for undertaking an audit. Although we recommend collecting as much information as possible to identify any problems, potential solutions or team learning, this is up to your clinical lead to determine.

The tool reflects the quality metrics (outcome and process measures) listed by the national best-practice critical haemorrhage bundle of care. These metrics, shown in the following table, act as markers of system efficiency and reflect the ideal pathway of care for a critically haemorrhaging trauma patient from site of injury to definitive bleeding control and the delivery of key therapies. They also provide a point of reference for services to review their processes of care and identify areas for improvement through the audit process.

Trauma haemorrhage simulation training checklist

Simulation training creates an opportunity to understand and support system and process change, while considering site-specific challenges and human factors that can influence how the national best-practice critical haemorrhage bundle of care guidelines are applied within an organisation.

This checklist is intended to be used as a guide for running an in-situ simulation of a critically haemorrhaging trauma patient in an emergency department (ED). Some criteria may not be relevant at every locality depending on infrastructure.