Ruchholtz et al identified trauma patients who required blood transfusion in the Emergency Department. The authors are from University Hospital Essen and University Witten/Herdecke in Germany.
Patient selection: severe trauma
Outcome: transfusion in the Emergency Department
Parameter:
(1) age in years
(2) admission
(3) trauma mechanism
(4) systolic blood pressure in mm Hg on admission
(5) free fluid on abdominal ultrasound
(6) pelvis on clinical exam
Parameter
Finding
Points
age in years
< 20 years
0
20 to 60 years
0.5
> 60 years
1.5
admission
from scene
1
transfer from other hospital
0
other
0
trauma mechanism
traffic accident
1
fall from height > 3 meters
1
other
0
systolic blood pressure
< 90 mm Hg
2.5
90 to 120 mm Hg
1.5
> 120 mm Hg
0
free fluid on abdominal US
absent
0
present
2
pelvis on clinical exam
stable
0
unstable
1.5
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9.5
• The higher the score the greater the risk of transfusion in the Emergency Room.
Score
Risk Transfusion
0
0.2%
1
0.7%
2
2%
2.5
3%
3
5%
4
12%
5
27%
6
50%
7
73%
9.5
97%
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