Reducing retained hemothorax requires more than knowing the evidence and having the right device on hand. It requires a trauma service to adopt a new protocol consistently, across providers, shifts, and appropriate patient presentations. Based on prior CLR Medical implementations, successful roll-out follows three steps: build consensus, protocolize the practice, and measure outcomes.
Step 1: Build Consensus
Implementation starts with alignment. Trauma surgeons, advanced practice providers (APPs), trainees, nurses, clinical educators, unit managers, supply chain, and hospital leadership should each understand the need for the practice change and the evidence behind it.
The goal at this stage is to build a shared understanding of optimized hemothorax management and buy-in for the changes to workflow. Understanding, at least at a high level, the scope of the problem with current practice, the benefits of early irrigation, and how CLR supports protocolized irrigation, promotes buy-in and a shared vision for improvement.
Step 2: Protocolize the Practice
Once there is agreement on the approach, it needs to become a defined, repeatable protocol rather than a practice left to individual judgment.
A written protocol reduces variability and gives staff a clear process to follow when a thoracic trauma patient arrives. A written protocol also empowers team members to take ownership of their individual roles without waiting for direction. As an example, the bedside trauma nurse can grab a CLR Kit and warm saline at the same time the chest tube and chest drainage system are pulled, staying prepared to open each device and make connections as the physician or APP moves through the irrigation procedure.
An example hemothorax management protocol from Orlando Regional Medical Center is a useful starting reference: Retained Hemothorax guideline, Orlando Regional Medical Center.
The streamlined CLR procedure lends itself well to protocolization, even in the fast-paced environment of the trauma bay
Step 3: Measure Outcomes
Feeding back adherence and outcome data to healthcare providers drives refinements, protocol adherence, and buy-in. Are there specific times, shifts, or providers who are more likely to perform early irrigation than others? Are the devices appropriately stocked, ideally co-located with the chest tubes and chest drainage systems (e.g., Pleur-Evac)? Is additional training required?
Tracking patient outcomes, including rate of retained hemothorax post-CLR deployment, need for secondary interventions, chest tube duration, and length of stay, helps clarify whether incorporating CLR irrigation is producing the results the team expected.
The feedback loop is what supports a durable practice change with continued engagement beyond the initial rollout.
Prepare Ahead of the Surge
A rise in trauma volume puts pressure on every part of a hospital system, from the trauma bay to the ICU to OR scheduling. Programs that build consensus, protocolize thoracic irrigation, and track outcomes ahead of that pressure are the ones that respond with more consistency once volume increases.
Contact CLR Medical to bring evidence-based thoracic irrigation to your center : clrmedical.com