Document Detail


External blood loss estimation using the MAR Method.
MedLine Citation:
PMID:  19931755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An element lacking in medical education is training to estimate blood volumes. Therefore, health care workers currently use visual estimation as their only means of determining blood volumes, which has shown to be highly inaccurate. This study proposes and tests a new method using one's fist to determine external blood loss. METHODS: Increments of human whole blood were measured and used to compare fist size to surface area of blood present. A formula was created averaging blood per fist, hereafter known as the MAR Method. Two scenarios were staged using set quantities of blood (75 and 750 mL). Participants estimated blood volumes before and after being taught the MAR Method in a 1-minute session. Errors in estimation before and after using the MAR Method were compared. RESULTS: The MAR Method was created using a fist to cover a surface area of blood that equals 20 mL. A total of 74 participants had errors of 120% and 73% for visualization of the small and large pools, respectively. For the smaller volume, the average error from the mean decreased by 76% (P < .0001), and the interquartile range of errors decreased by 60%. For the larger volume, the average error from the mean reduced by 40% (P < .0001), and the interquartile range of errors reduced by 45%. CONCLUSION: Use of the MAR Method improves blood volume estimations. After less than 1 minute of instruction, participants were able to determine blood volumes with improved accuracy and precision.
Authors:
Mark A Merlin; Scott M Alter; Brian Raffel; Peter W Pryor
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  27     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1085-90     Citation Subset:  IM    
Affiliation:
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School Department of Emergency Medicine, New Brunswick, NJ 08901, USA. merlinma@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Volume Determination / methods*
Clinical Competence
Emergency Medicine / education*
Emergency Service, Hospital
Female
Hand
Hemorrhage / diagnosis*
Humans
Male
Reproducibility of Results
Triage

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


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