Analysis on Trauma Patients in Different Application System of Transfusion

Wi,  Dae han

J Korean Soc Emerg Med > Volume 18(6); 2007 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2007;18(6): 529-536.

Analysis on Trauma Patients in Different Application System of Transfusion

Dae han Wi

Department of Emergency Medicine, School of Medicine, Wonkwang University, Iksan, Korea. great@wonkwang.ac.kr

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.

Key words: Blood Transfusion, Multiple Trauma