Evidence map›Paper›PMID 35720867›Full record

ArticlePediatric quality & safety

Reducing the Time to Blood Administration after Pediatric Injury: A Quality Improvement Initiative.

Travis M Sullivan, Zachary P Milestone, Emily C Alberto, Elizabeth M Waibel, Waverly V Gestrich-Thompson, Peyton E Tempel, Jennifer L Fritzeen, Karen J O'Connell, Jacob Cheng, Randall S Burd

Abstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. 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 · 2026
    Article
  2. Article
  3. Article
  4. Time is tissue: Barriers to timely transfusion after pediatric injury.The journal of trauma and acute care surgery · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Travis M SullivanDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Zachary P MilestoneDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Emily C AlbertoDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Elizabeth M WaibelDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Waverly V Gestrich-ThompsonDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Peyton E TempelDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Jennifer L FritzeenDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.
Karen J O'ConnellDivision of Emergency Medicine, Children's National Hospital, Washington, D.C.
Jacob ChengDepartment of Quality and Patient Safety, Children's National Hospital, Washington, D.C.
Randall S BurdDivision of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C.

Funding

Intention-aware Recommender System for Improving Trauma Resuscitation OutcomesR01LM011834 · NLM · CHILDREN'S RESEARCH INSTITUTE · PI BURD, RANDALL S., MARSIC, IVAN · 2014 to 2023
$4.7M
6 · The paper itself

Abstract

Introduction: Hemorrhage is the leading cause of preventable death in pediatric trauma patients. Timely blood administration is associated with improved outcomes in children and adults. This study aimed to identify delays to transfusion and improve the time to blood administration among injured children. Methods: A multidisciplinary team identified three activities associated with blood transfusion delays during the acute resuscitation of injured children. To address delays related to these activities, we relocated the storage of un-crossmatched blood to the emergency department (ED), created and disseminated an intravenous access algorithm, and established a nursing educator role for resuscitations. We performed comparative and regression analyses to identify the impact of these factors on the timeliness and likelihood of blood administration. Results: From January 2017 to June 2021, we treated 2159 injured children and adolescents in the resuscitation area, 54 (2.5%) of whom received blood products in the ED. After placing a blood storage refrigerator in the ED, we observed a centerline change that lowered the adjusted time-to-blood administration to 17 minutes (SD 11), reducing the time-to-blood administration by 11 minutes (β = -11.0, 95% CI = -22.0 to -0.9). The likelihood of blood administration was not changed after placement of the blood refrigerator. We observed no reduction in time following the implementation of the intravenous access algorithm or a nursing educator. Conclusions: Relocation of un-crossmatched blood storage to the ED decreased the time to blood transfusion. This system-based intervention should be considered a strategy for reducing delays in transfusion in time-critical settings.

Identifiers

PMID35720867
PMCPMC9197352

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.