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Adult-Based Massive Transfusion Protocol Activation Criteria Do Not Work in Children by Acker, Shannon; Hall, Brianne; Hill, Lauren; Partrick, David; Bensard, Denis is a Medicine article available to read on EtoBox.

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In the adult population, assessment of blood consumption (ABC) score [penetrating mechanism, positive focused assessment sonography for trauma (FAST), systolic blood pressure 120] ≥2 identifies trauma patients who require massive transfusion (MT) with sensitivity and specificity of 75 and 86%. We hypothesized that the adult criteria cannot be applied to children, as the vital sign cut-offs are not age-adjusted. We aimed to determine if the use of a shock index, pediatric age-adjusted (SIPA) would improve the discriminate ability of the ABC score in children. A retrospective review of children age 4 to 15 who received a packed red blood cell (PRBC) transfusion during admission for trauma between 2008 and 2014 was performed. We compared the sensitivity and specificity of ABC score ≥ 2, elevated SIPA, and age-adjusted ABC score (ABC-S) utilizing SIPA in place of HR and BP, to determine the need for MT. A total of 50 children were included, 31 received PRBC transfusion within 6 hours of injury, 7 children had a positive FAST, and 3 suffered penetrating trauma, all in the early transfusion group. ABC score ≥ 2 is 29% sensitive and 100% specific at predicting need for MT while ABC-S

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Author

Acker, Shannon; Hall, Brianne; Hill, Lauren; Partrick, David; Bensard, Denis

Publisher

Thieme Medical Publishers; Georg Thieme Verlag KG; Georg Thieme Verlag (ISSN 0939-7248)

Published

2016

Language

EN

Field

Medicine (Health Sciences)