Logistics of Massive Transfusions

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 470-473 ◽  
Author(s):  
Thomas G. DeLoughery
Keyword(s):  
Emergency Department ◽  
Massive Bleeding ◽  
Blood Bank ◽  
Trauma Patients ◽  
Blood Products ◽  
Proper Management ◽  
Surgical Suite

Abstract Care of the patient with massive bleeding involves more than aggressive surgery and infusion of large amounts of blood products. The proper management of massive transfusions—whether they are in trauma patients or other bleeding patients—requires coordination of the personnel in the surgical suite or the emergency department, the blood bank, and laboratory.

Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow

2021 ◽  
pp. 084653712110238
Author(s):  
Francesco Macri ◽  
Bonnie T. Niu ◽  
Shannon Erdelyi ◽  
John R. Mayo ◽  
Faisal Khosa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Major Trauma ◽  
Patient Flow ◽  
Interrupted Time Series ◽  
Trauma Patients ◽  
Linear Regression Models ◽  
High Acuity ◽  
Time Series Approach ◽  
Comparison Series ◽  
The Impact

Purpose: Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital. Methods: Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint. Results: During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern. Conclusions: At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.

scholarly journals Prehospital resuscitation

2021 ◽  
Vol 6 (1) ◽  
pp. e000729
Author(s):  
Alexandra M P Brito ◽  
Martin Schreiber
Keyword(s):  
Young People ◽  
Tranexamic Acid ◽  
New Technologies ◽  
Blood Product ◽  
Traumatic Injury ◽  
Trauma Patients ◽  
Blood Products ◽  
Front Line ◽  
The Usa ◽  
Review Current

Traumatic injury is the leading cause of death in young people in the USA. Our knowledge of prehospital resuscitation is constantly evolving and is often informed by research based on military experience. A move toward balanced blood product resuscitation and away from excessive crystalloid use has led to improvements in outcomes for trauma patients. This has been facilitated by new technologies allowing more front-line use of blood products as well as use of tranexamic acid in the prehospital setting. In this article, we review current practices in prehospital resuscitation and the studies that have informed these practices.

Effective Triage Can Ameliorate the Deleterious Effects of Delayed Transfer of Trauma Patients from the Emergency Department to the ICU

2009 ◽  
Vol 208 (5) ◽  
pp. 671-678 ◽  
Author(s):  
J. David Richardson ◽  
Glen Franklin ◽  
Ariel Santos ◽  
Brian Harbrecht ◽  
Dan Danzl ◽  
...  
Keyword(s):  
Emergency Department ◽  
Trauma Patients

Changes in Coagulation in Standard Laboratory Tests and ROTEM in Trauma Patients Between On-Scene and Arrival in the Emergency Department

2015 ◽  
Vol 120 (3) ◽  
pp. 627-635 ◽  
Author(s):  
Oliver M. Theusinger ◽  
Werner Baulig ◽  
Burkhardt Seifert ◽  
Stefan M. Müller ◽  
Sergio Mariotti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Laboratory Tests ◽  
Trauma Patients ◽  
Standard Laboratory

scholarly journals Defining criteria to choose appropriate destination hospital for trauma patients: Piacenza Local Health Authority’s Piacenza trauma algorithm protocol

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Fabio Mozzarelli ◽  
Stefano Nani ◽  
Enrica Rossi ◽  
Mario Pizzamiglio
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Observational Study ◽  
Electronic Device ◽  
Local Health ◽  
Trauma Patients ◽  
Medical Facility ◽  
Provincial Hospital ◽  
Trauma Algorithm ◽  
Data Context

Ambulance crew’s choosing of appropriate destination hospital for trauma patients can affect survival and morbidity outcomes. Aim of the present study is to devise a decision-making algorithm in order to allow the best choice of destination hospital for trauma patients and to apply it on an electronic device able to facilitate the decision made by ambulance staff. The method used was analysis of literature data, context and workload with a retrospective observational study. A comparison between the destination hospitals actually chosen and those that could have been chosen with the <em>Piacenza trauma algorithm</em> has been applied. The data shows a 9.5% (P&gt;0.10) more advantageous change in appropriateness in the choice of medical facility and a 1.4% increase in admissions to the Emergency Department of the provincial hospital. The creation and use of a medical protocol and its consequent installation on an electronic device (tablet) that can be shared over a computer platform could help medical staff make appropriate pre-hospital choices as regards the destination hospital for trauma patients.

scholarly journals Factors Affecting the Likelihood of Presentation to the Emergency Department of Trauma Patients After Discharge

2011 ◽  
Vol 58 (5) ◽  
pp. 431-437 ◽  
Author(s):  
Karim S. Ladha ◽  
J. Hunter Young ◽  
Derek K. Ng ◽  
David T. Efron ◽  
Adil H. Haider
Keyword(s):  
Emergency Department ◽  
Trauma Patients ◽  
Factors Affecting

scholarly journals Bacterial Contamination of Blood and Blood Products at Mbarara Regional Blood Bank in Rural South Western Uganda

2013 ◽  
Vol 03 (03) ◽  
pp. 205-209 ◽  
Author(s):  
G. B. Matte Aloysius ◽  
Bazira Joel ◽  
Richard Apecu ◽  
Boum Yap II ◽  
Frederick Byarugaba
Keyword(s):  
Bacterial Contamination ◽  
Blood Bank ◽  
Blood Products ◽  
Rural South ◽  
Western Uganda
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