Paydar et al reported the Shiraz Trauma Transfusion Score. This can help guide how a trauma patient is resuscitated. The authors are from Shiraz University of Medical Sciences in Iran and Univeristy Hospital Zurich.
Patient selection: trauma patient
Parameters after receiving an inital 2 liters of crystalloid
(1) mechanism of trauma
(2) pre-existing conditions
(3) systolic blood pressure in mm Hg
(4) heart rate in beats per minute
(5) hemoglobin in g/dL
(6) base excess in mmol/L (acidosis)
Parameter
Finding
Points
mechanism
other
0
penetrating trauma
1
multiple trauma without brain injury
2
multiple with brain injury
3
pre-existing conditions
none
0
anticoagulant, beta-blcoker, diabetes, old age
1
cardiovascular disease, lung disease
2
systolic blood pressure
> 100 mm Hg
0
80 to 100 mm Hg
2
< 80 mm Hg
4
heart rate
< 100 per minute
0
100 to 120 per minute
1
> 120 beats per minute
2
hemoglobin
> 10 g/dL
0
7 to 10 g/dL
3
< 7 g/dL
4
base excess
> -6
0
-6 to -10
2
< -10 (acidosis)
4
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 19
Score
Hemoglobin
Therapy
< 5
NA
no transfusion
5 to 7
<= 16 g/dL
transfuse RBCs one by one
5 to 7
> 16
continue colloids or crystalloids
>= 8
NA
transfuse RBCs two by two, plus FFP and tranexamic acid
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