Avital et al reported a score for identifying a trauma patient coming to the Emergency Department (ED) who may need an emergency blood product transfusion. The authors are from multiple institutions in Israel and the United States.
Patient selection: trauma patient prior to arrival at the hospital
Prehospital parameters:
(1) lowest systolic blood pressure in mm Hg
(2) highest heart rate in beats per minute
(3) lowest SpO2 in percent
(4) injured region
(5) mechanism of injury
(6) tourniquet application
(7) chest decompression or drainage
Parameter
Finding
Points
lowest systolic BP
>= 90 mm Hg
0
< 90 mm Hg
2.5
highest heart rate
<= 130 bpm
0
> 130 bpm
2
lowest SpO2
>= 90 percent
0
< 90 percent
1
injured region
trunk
1
other
0
mechanism of injury
gunshot
2
motor vehicle
1.5
other
0
tourniquet application
no
0
yes
1.5
chest decompression or drainage
no
0
yes
1.5
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 11.5
• The higher the score the greater the need for transfusion.
Total Score
Risk Transfusion
0 or 1
0.8% (very low)
1.5 or 2
3.2% (low)
2.5 to 3.5
8.5% (intermediate)
4 to 11.5
31.2% (high)
Performance:
• The area under the ROC curve is 0.96.
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