Analysis on Trauma Patients in Different Application System of Transfusion

Wi, Dae han

Abstract

PURPOSE: Patients who are hemodynamically unstable because of severe trauma may require very early transfusion during their care in the emergency center. I employed a four-level scoring system in order to shorten the interval from evaluation to treatment in early transfusion.
METHODS
Trauma patients receiving transfusions, who visited our emergency center from May 2003 to December 2006 were retrospectively recruited. The scoring system consisted of four levels; "most urgent" or level I, "urgent" or level II, "emergent" or level III and "routine" or level IV. Type O/Rh(+) bloods were transfused for the most urgent level, type-specific bloods were transfused for the urgent level, type-specific and incompletely cross-matched bloods were transfused for the emergent level, and fully crossmatched bloods were transfused for the routine level.
RESULTS
The mean interval from evaluation to treatment with transfusion was 4.4+/-1.8 min in the most urgent group, 15.5+/-8.4 min in the urgent group, 36.4+/-17.3 min in the emergent group, and 70.5+/-25.9 min in the routine group. The cut-off values ware < or =90 mmHg for systolic blood pressure, < or =6.9 for revised trauma score, and > or =4.5 for emergency room transfusion score.
CONCLUSION
Establishment of a four-tiered scoring system for treatment of severe trauma patients by early transfusion was successful in shortening the interval between evaluation and initiation of transfusion. Patients who do not meet cut-off values require careful observation.