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% |
Specialty: Clinical Laboratory, Surgery, orthopedic