ArticleTrauma surgery & acute care open2018
Experience with uncrossmatched blood refrigerator in emergency department.
Article in Trauma surgery & acute care open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Association between time to transfusion and outcomes in patients with traumatic haemorrhagic shock: an analysis of a nationwide trauma registry in Japan.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Emergency transfusion of uncross-matched O-type red blood cells in patients with severe pelvic fracture: a multi-center propensity score-weighted analysis.World journal of emergency medicine · 2026Article
- Major Bleeding in the Emergency Department: A Practical Guide for Optimal Management.Journal of clinical medicine · 2025Review
- Timing and volume of transfusion for adult major trauma patients with hemorrhagic shock: a registry-based cohort study.Trauma surgery & acute care open · 2024Article
- Time is tissue: Barriers to timely transfusion after pediatric injury.The journal of trauma and acute care surgery · 2023Review
- Reducing the Time to Blood Administration after Pediatric Injury: A Quality Improvement Initiative.Pediatric quality & safetyArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUncrossmatched packed red blood cell (PRBC) transfusion is fundamental in resuscitation of hemorrhagic shock. Ready availability of uncrossmatched blood can be achieved by storing uncrossmatched blood in a blood bank refrigerator in the emergency department (ED), but could theoretically lead to inappropriate uncrossmatched use.
methodsThis retrospective study was performed at a level I trauma center from January 2013 to March 2014. Possibly inappropriate transfusion was defined as patients who received at least one unit of blood from the ED refrigerator and no more than two units of PRBC in the first 24 hours. Deaths within the first 24 hours were excluded. Patients who received blood from the ED refrigerator who received ≤2 units total in 24 hours were compared with those who received >2 units.
results158 adults received blood from the ED refrigerator. 140 (88.6%) were trauma patients. 37 (23.4%) received massive transfusion (MT). 42 (26.6%) deaths were excluded. 29 patients received ≤2 units and 87 received >2 units in the first 24 hours. The ≤2 units group had a higher systolic blood pressure (116 mm Hg vs. 102 mm Hg, p=0.042), lower base deficit (6.4 mEq/L vs. 9.4 mEq/L, p=0.032), higher hematocrit (34% vs. 30%, p=0.024), lower rate of MT protocol activation (27.6% vs. 58.6%, p=0.005), and lower rates of transfusion of fresh frozen plasma (17.2% vs. 54.0%, p=0.001) and platelets (13.8% vs. 39.1%, p=0.012). Appropriately transfused patients were more likely to have evidence of shock with active, non-compressible hemorrhage. Potentially inappropriate uses were more likely in patients either without evidence of hemorrhage or without signs of shock. DISCUSSION: Storing uncrossmatched blood in the ED is an effective way to get PRBCs transfused quickly in hemorrhaging patients and is associated with a low rate of unnecessary uncrossmatched transfusion. Provider education and good clinical judgment are imperative to prevent unnecessary use. LEVEL OF EVIDENCE: Level III, therapeutic.
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