| Emergency department staff knowledge of massive transfusion for trauma: the need for an evidence based protocol. | |
| | |
MedLine Citation:
|
PMID: 21030544 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Uncontrolled haemorrhage is the leading cause of potentially reversible early in-hospital death following trauma. Approximately 25% of trauma patients arriving in the emergency department have evidence of early coagulopathy. It is vital that staff within the emergency department understand the basic pathophysiological consequences of massive blood loss in trauma and are familiar with when and how to administer blood and specific blood components in trauma resuscitation. METHODS: A structured questionnaire designed to test knowledge of the use of blood and blood components in trauma resuscitation was distributed to the emergency physicians attending a regional conference in the South West of England. The questionnaire consisted of 16 questions, both multiple choice and short answer format, referenced via Medline. RESULTS: 32/32 questionnaires distributed were completed and returned. Massive transfusion protocols existed in 4/11 hospitals surveyed. 5/32 doctors were able to define the term 'massive transfusion' while 9/32, 6/32 and 3/32 were consistent with current guidelines in their prescription of platelets, fresh frozen plasma, and cryoprecipitate. 20/32 were consistent with current guidelines in identifying optimal haemoglobin levels. When asked more specifically about blood component therapy, 18/32 correctly identified target fibrinogen levels, 27/32 knew that fibrinogen is a component of fresh frozen plasma or cryoprecipitate and 1/32 correctly identified that fibrinogen is a component of both. 10/32 identified indications for beriplex and 5/32 doctors correctly identified indications for the use of recombinant factor VIIa. 20/32 doctors guessed >50% of the answers and the remaining 12/32 guessed 50%. CONCLUSIONS: The survey found that emergency physicians lacked core knowledge about the use of blood and blood component therapy in the context of massive haemorrhage following trauma. Doctors were unaware of how to prevent and treat early coagulopathy. Educational resources specifically for use by emergency physicians are limited on this topic. The use of massive transfusion protocols--that standardised blood component therapy is automatically delivered at specific points within resuscitation--would not only guide doctors, but be a clear step towards minimising the complications associated with massive transfusion. |
| | |
Authors:
|
C Milligan; I Higginson; J E Smith |
Related Documents
:
|
2916144 - Immediate prediction of blood requirements in trauma victims. 16104404 - Effective distribution of domestic wastewater effluent between percolation trenches in ... 11126594 - Improved efficiency in providing blood to surgical patients using a novel approach to p... 11452154 - Wbc-reduced blood transfusions and clinical outcome in children with acute lymphoid leu... 11119074 - Low power laser protects human erythrocytes in an in vitro model of artificial heart-lu... 2916144 - Immediate prediction of blood requirements in trauma victims. |
Publication Detail:
|
Type: Journal Article Date: 2010-10-28 |
Journal Detail:
|
Title: Emergency medicine journal : EMJ Volume: 28 ISSN: 1472-0213 ISO Abbreviation: Emerg Med J Publication Date: 2011 Oct |
Date Detail:
|
Created Date: 2011-09-15 Completed Date: 2011-12-14 Revised Date: 2012-02-16 |
Medline Journal Info:
|
Nlm Unique ID: 100963089 Medline TA: Emerg Med J Country: England |
Other Details:
|
Languages: eng Pagination: 870-2 Citation Subset: IM |
Affiliation:
|
Emergency Department, Derriford Hospital, Plymouth PL68DH, UK. milli@doctors.org.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Blood Transfusion*
/
methods Clinical Competence* Clinical Protocols / standards Emergency Medicine / education* Emergency Service, Hospital / standards England Humans Medical Staff, Hospital* Physician's Practice Patterns Questionnaires Shock, Hemorrhagic / prevention & control, therapy* Wounds and Injuries / therapy* |
| Comments/Corrections | |
Comment In:
|
Emerg Med J. 2012 Feb;29(2):168
[PMID:
22034536
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Time lag to hospitalisation and the associated determinants in patients with acute myocardial infarc...
Next Document: Procedural sedation and recall in the emergency department: the relationship between depth of sedati...