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KMID : 0385920070180060529
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Journal of the Korean Society of Emergency Medicine
2007 Volume.18 No. 6 p.529 ~ p.536
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Analysis on Trauma Patients in Different Application System of Transfusion
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Wi Dae-Han
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Abstract
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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.
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KEYWORD
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Blood Transfusion, Multiple Trauma
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