Type and crossmatch of the trauma patient

Objective: To identify a population of trauma patients in the emergency dep artment (ED) that do not require emergent blood transfusion via a combinati on of clinical risk factors that are readily accessible and easily obtained , Method: A review of trauma patients pas conducted for a 6-month period. Cro ssmatched patients were identified and examined for clinical characteristic s and whether transfusion was performed, Risk factors for transfusion were identified and a model was developed for predicting likelihood of transfusi on. Results: Six: hundred fifty-four patients were crossmatched, with emergent transfusion occurring in 81 (12.4%). Four risk factors were identified: sys tolic blood pressure < 90 mm Hg, Glasgow Coma Scale score < 9, pulse > 120 beats/min, and high-risk injury (trauma to the chest between the midclavicu lar lines, abdominal injury with diffuse tenderness, survival of a fatal ve hicular crash, ejection from a vehicle, or stab or gunshot wound to the tru nk), Patients with no risk factors were shown to have a 2.2% incidence of t ransfusion with no emergent transfusions occurring in the ED. Conclusion: Trauma patients with no risk factors at presentation were less likely to require emergent blood transfusion, especially in the setting of the ED.