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Editorial
Vascular accident code: A security system in massive bleeding in laparoscopic urologic surgery
Código accidente vascular: un sistema de seguridad ante un sangrado masivo en la cirugía urológica laparoscópica
Á. Juárez-Sotoa, M. Pérez-Garcíab, M. Fuentes-Curtidoa, C. Guisado-Martina, M. Hernández-Garridoa, M.A. Arrabal-Poloc,
Corresponding author
arrabalp@ono.com

Corresponding author.
, M. de Paz-Suárezb
a Servicio de Urología, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain
b Servicio de Anestesiología, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain
c Complejo Hospitalario Universitario Granada, Instituto IBS Granada, Granada, Spain
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thromboembolic prophylaxis&#44; proper management of chronic medication&#44; anesthetic management&#44; in addition to a checklist of the patient&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient that will undergo surgery is exposed to certain risks since starting the pre-anesthesia consultation until the postoperative period&#44; so it is essential to establish a series of stages and stratify the risk to implement protocols and measures to improve patient safety&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">From the multiple complications from surgery&#44; one of the most severe for the patient is the massive bleeding from vascular injury&#44; in which in many cases massive transfusion is required&#44;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">5&#44;6</span></a> and it can even cause patient death&#46; Therefore&#44; we consider it necessary to implement a security protocol to improve and optimize the results when a severe or very severe stroke happens during surgery&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Our goal is to establish a standard operating procedure &#40;SOP&#41; to enable coordinated multidisciplinary action in the event of a stroke and which we will call &#8216;stroke code&#8217;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protocol development and initial results</span><p id="par0025" class="elsevierStylePara elsevierViewall">In this SOP&#44; &#8216;stroke code&#8217;&#44; all professionals&#44; health and non-health&#44; that integrate the surgical and support team are involved&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The SOP has 3 clearly differentiated stages&#44; the pre-operative stage&#44; consisting of the preparation of the operating room and pre-surgery actions&#44; activation of the &#8216;stroke code&#8217;&#44; which is the state of general alert that occurs when operating a patient at risk of massive bleeding and implementation of the &#8216;stroke code&#8217;&#44; which is when in the code activation situation&#44; massive bleeding occurs&#46; These stages are detailed in <a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The preoperative stage includes all pre-surgery actions that will have an impact on the optimization of the results in safety&#44; if massive bleeding occurs during surgery&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The stage &#8216;stroke code activation&#8217; is the status of passive alert of the professionals involved in surgery&#44; each assuming the appropriate role according to the SOP&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The stage &#8216;stroke code execution&#8217; is the status of active alert that is generated when a stroke occurs de facto&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The day of surgery&#44; SOP leadership is responsibility for the coordination of the code&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Its role is&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><p id="par0060" class="elsevierStylePara elsevierViewall">Presurgical stage<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Coordinating the entire surgical team and ensuring knowledge of the SOP &#8216;stroke code&#8217;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;2&#41;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Identifying the day of surgery&#44; those support professionals who are not usually part of the surgical team&#44; and explaining to them the SOP and their responsibility in it&#44; and confirm that they understand&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;3&#41;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Checking points 1 and 2 before the start of the surgery&#46;</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0025"><p id="par0080" class="elsevierStylePara elsevierViewall">Code activation stage<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Checking all the elements of security&#44; passive alert&#44; and actions contained in the SOP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#40;2&#41;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Ensuring their compliance by professionals&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#40;3&#41;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Deactivating the code&#44; once past the risk of massive bleeding&#46;</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0045"><p id="par0100" class="elsevierStylePara elsevierViewall">Stage of code execution<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Coordinating the implementation by the professionals who make up the surgical team of each and every one of the planned actions&#44; if massive bleeding occurs&#46;</p></li></ul></p></li></ul></p><p id="par0110" class="elsevierStylePara elsevierViewall">After having finished the surgery and deactivated the &#8216;stroke code&#8217;&#44; the Security Committee of the Clinical Management Unit of Urology is summoned&#44; where the operation of surgical systems established and the establishment of areas for improvement if necessary are evaluated by professionals&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In the Urology Department of the Hospital de Jerez&#44; we activated the SOP &#8216;stroke code&#8217; in high-risk cases of massive bleeding&#44; such as surgery of large renal masses with vascular infiltration&#44; surgery of retroperitoneal masses adjacent to the great vessels&#44; surgery of xanthogranulomatous pyelonephritis&#44; etc&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">We did not apply it to simple nephrectomies&#44; partial nephrectomies&#44; radical prostatectomies&#44; or cystectomies&#44; unless they have some characteristic that makes a massive bleeding likely&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Since the implementation of the SOP &#8216;stroke code&#8217; in 2011&#44; until January 2016&#44; we applied it to 32 patients&#46; The SOP has been modified on 3 occasions &#40;currently in force its 4th edition&#41;&#44; incorporating in each of them the improvements to address the weaknesses identified during the activation and&#47;or execution of the &#8216;stroke code&#8217;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The main weaknesses&#44; which caused SOP modifications&#44; were&#58;<ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">1&#46;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Interprofessional communication problems&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">2&#46;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Lack of awareness of some professionals of the urology team&#44; with attitudes that caused deconcentration of the surgical team at risk &#40;during an extension of surgery&#44; requesting shift change and leaving operating room unattended&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">3&#46;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Lack of awareness of some professionals outside the operating room of urology who&#44; due to ignoring the importance of the SOP&#44; came into the operating room for reasons not related to it&#44; causing deconcentration of the team in difficult moments of the surgery&#46;</p></li></ul></p><p id="par0150" class="elsevierStylePara elsevierViewall">The &#8216;stroke code&#8217; has been executed on 3 occasions due to massive bleeding &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#44; the surgical team acting with order&#44; calm&#44; and security&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">All vascular accidents that occurred since the introduction of the SOP have been resolved laparoscopically&#44; which was rare before implantation thereof&#44; which we always opted to convert to open surgery&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The &#8216;stroke code&#8217; is a powerful tool to transform the chaos and uncertainty in a critical situation&#44; in order&#44; calm of the team&#44; and safety for the patient and for professionals&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">When all team members know how to act each individually and have the certainty that the rest know what to do&#44; calm and good governance flood the operating room&#46; Professionals know that there may be a surgical accident&#44; but that with the SOP &#8216;stroke code&#8217;&#44; they are prepared to act with the greatest possible safety for the patient&#46; A stroke during surgery may have a fatal outcome&#44; but with the &#8216;stroke code&#8217; tool&#44; it will not be because of unsafe acts by professionals&#44; or due to lack of foresight or the organization&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">This SOP has limitations as it is a project of the Department of Urology at the Hospital de Jerez&#44; but we consider it a powerful tool that provides security to patients undergoing high-risk interventions of massive bleeding and professionals of urology&#46;</p></span></span>"
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                  "referenciaCompleta" => "Bachiller Burgos J&#46; Comit&#233; Operativo para la Seguridad del Paciente&#46; Consejer&#237;a de Salud&#46; Junta de Andaluc&#237;a&#46;"
                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Manual de Seguridad del Paciente Quir&#250;rgico &#8211; Servicio C&#225;ntabro de Salud &#40;SCS&#41;"
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                        0 => array:2 [
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                          "autores" => array:4 [
                            0 => "L&#46; Pino Dom&#237;nguez"
                            1 => "H&#46; Rebollo Rodrigo"
                            2 => "J&#46; Sanz Salanova"
                            3 => "T&#46; Valle Madrazo"
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                  ]
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                        "edicion" => "1&#46;&#170; ed&#46;"
                        "fecha" => "2014"
                        "editorial" => "Imprenta Regional de Cantabria"
                        "editorialLocalizacion" => "Santander"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incompetent surgery is found not isolated"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;E&#46; Brody"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1976"
                        "paginaInicial" => "24"
                        "editorial" => "New York Times"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seguridad quir&#250;rgica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Combalia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "JANO"
                        "fecha" => "2011"
                        "paginaInicial" => "63"
                        "paginaFinal" => "69"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transfusi&#243;n masiva y manejo del paciente traumatizado&#58; enfoque fisiopatol&#243;gico del tratamiento"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Zunini Fern&#225;ndez"
                            1 => "K&#46; Rando-Huluk"
                            2 => "F&#46;J&#46; Mart&#237;nez-Pelayo"
                            3 => "A&#46;L&#46; Castillo-Trevizo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cir Cir"
                        "fecha" => "2011"
                        "volumen" => "79"
                        "paginaInicial" => "473"
                        "paginaFinal" => "480"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22385770"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Grupo de trabajo de la Gu&#237;a de Pr&#225;ctica Cl&#237;nica para la Seguridad del Paciente Quir&#250;rgico&#46; Centro Cochrane Iberoamericano&#44; coordinador&#46; Gu&#237;a de Pr&#225;ctica Cl&#237;nica para la Seguridad del Paciente Quir&#250;rgico&#46; Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad&#44; Pol&#237;tica Social e Igualdad&#46; Ag&#232;ncia d¿Informaci&#243;&#44; Avaluaci&#243; i Qualitat en Salut &#40;AIAQS&#41; de Catalu&#241;a&#59; 2010&#46; Gu&#237;as de Pr&#225;ctica Cl&#237;nica en el SNS&#58; AATRM N&#46;&#176; 2007&#47;24&#46;"
                ]
              ]
            ]
          ]
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Original language: English
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