Hamada et al developed a prehospital "red flag" alert to identify a patient with blunt trauma who may have major hemorrhage. This can help prepare the trauma team for the patient's arrival. The authors are from multiple institutions in France.
Patient: blunt trauma
Parameters:
(1) pelvis status
(2) shock index
(3) oro-tracheal intubation
(4) hemoglobin in g/dL
(5) mean arterial blood pressure
Parameter
Finding
Points
pelvis status
stable
0
unstable
1
shock index
< 1
0
>= 1
1
oro-tracheal intubation
no
0
yes
1
hemoglobin
> 13 g/dL
0
<= 13 g/dL
1
mean arterial pressure
> 70
0
<= 70
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >= 2 should activate the hemorrhage control response team.
Performance:
• The area under the ROC curve was 0.83.
• The sensitivity was 75% and specificity 79%.
• The significance of the hemoglobin may be limited if the patient was female or anemic before
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