Document Detail


Accuracy of the Prehospital Index in identifying major hemorrhage in trauma victims.
MedLine Citation:
PMID:  10146304     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the sensitivity of the Prehospital Index (PHI) in identifying patients with severe blood loss, a one-year review was conducted at a regional trauma facility.
METHODS: The study population consisted of 217 consecutive trauma admissions (ages 3 to 88 years). Patients were managed using standard resuscitation techniques; blood transfusions were ordered at the discretion of attending physicians and did not follow any preplanned protocol. Medical records were examined to determine total blood requirements for each patient during the first 12 hours of hospitalization, the emergency department (ED) disposition, and final outcome of treatment. The following clinical variables were analyzed (unpaired t-test) to determine their value as predictors of blood loss: age, gender, mechanism of injury, initial vital signs, revised trauma score, PHI, and injury severity score.
RESULTS: Forty-two percent (92 patients) received transfusions during the first 12 hours of hospitalization. The best predictor of blood loss was the Prehospital Index. Of the total group, 45% had a PHI greater than 3; 77% (75/98) of these patients required transfusion and received an average of 7.1 units of packed cells. Fifty-five percent (119/217) had a PHI less than or equal to 3; 86% (102/119) of these patients did not require transfusion.
CONCLUSION: The data suggest that patients with PHI scores greater than 3 require close hemodynamic monitoring to rule out significant blood loss and may warrant immediate cross-matching on arrival to the ED.
Authors:
J Jones; C Newman; J Krohmer; C Mattice
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prehospital and disaster medicine     Volume:  8     ISSN:  1049-023X     ISO Abbreviation:  Prehosp Disaster Med     Publication Date:    1993 Jul-Sep
Date Detail:
Created Date:  1994-01-27     Completed Date:  1994-01-27     Revised Date:  2011-12-15    
Medline Journal Info:
Nlm Unique ID:  8918173     Medline TA:  Prehosp Disaster Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  237-40     Citation Subset:  T    
Affiliation:
Emergency Medicine Residency Program and Trauma Registry, Butterworth Hospital, Michigan State University College of Human Medicine, Grand Rapids 49503.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Blood Transfusion
Child
Child, Preschool
Emergency Medical Services*
Female
Hemorrhage / diagnosis*
Humans
Male
Middle Aged
Trauma Severity Indices

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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