Published: August 2025. Next review: 2030.
This clinical practice guide is for medical retrieval services and senior clinicians (trauma, emergency, surgical, intensive care, anaesthetics and radiology) in major adult, paediatric and regional trauma services.
This information does not replace any pre-existing in-hospital ‘Code Crimson’ pathways that hospitals may have in place. It provides recommendations on optimal responses to a trauma ‘Code Crimson’ activation.
‘Code Crimson’ is a term commonly used by hospital-based teams managing patients with life-threatening haemorrhage which cannot be controlled with resuscitation.
A ‘Code Crimson’ activation streamlines patient access to immediate definitive intervention, including an operating theatre or interventional radiology suite.
This guide provides recommendations to standardise the identification, activation, and response to a trauma ‘Code Crimson’ across pre-hospital and in-hospital settings.
Pre-hospital
- Identification of a trauma ‘Code Crimson’.
- Activation of a trauma ‘Code Crimson’ pathway by medical retrieval teams and the subsequent notification to a receiving trauma centre.
In hospital
- Receiving trauma centre response to a pre-hospital activation of trauma ‘Code Crimson’.
- Trauma centres response to an in-hospital activation of a trauma ‘Code Crimson’.