Type and crossmatch of the trauma patient

To identify a population of trauma patients in the emergency department (ED) that do not require emergent blood transfusion via a combination of clinical risk factors that are readily accessible and easily obtained.

A review of trauma patients was conducted for a 6-month period. Crossmatched patients were identified and examined for clinical characteristics and whether transfusion was performed. Risk factors for transfusion were identified and a model was developed for predicting likelihood of transfusion.

Six hundred fifty-four patients were crossmatched, with emergent transfusion occurring in 81 (12.4%). Four risk factors were identified: systolic blood pressure < 90 mm Hg, Glasgow Coma Scale score < 9, pulse > 120 beats/min, and high-risk injury (trauma to the chest between the midclavicular lines, abdominal injury with diffuse tenderness, survival of a fatal vehicular crash, ejection from a vehicle, or stab or gunshot wound to the trunk). Patients with no risk factors were shown to have a 2.2% incidence of transfusion with no emergent transfusions occurring in the ED.

Trauma patients with no risk factors at presentation were less likely to require emergent blood transfusion, especially in the setting of the ED.