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首页> 外文期刊>African Journal of Emergency Medicine >Estimated injury-associated blood loss versus availability of emergency blood products at a district-level public hospital in Cape Town, South Africa
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Estimated injury-associated blood loss versus availability of emergency blood products at a district-level public hospital in Cape Town, South Africa

机译：南非开普敦地区级公立医院估计的与伤害有关的失血与急诊血液制品的供应量

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IntroductionInternational guidance suggests that injury-associated haemorrhagic shock should be resuscitated using blood products. However, in low- and middle-income countries resuscitation emphasises the use of crystalloids – mainly due to poor access to blood products. This study aimed to estimate the amount of blood loss from serious injury in relation to available emergency blood products at a secondary-level, public Cape Town hospital.MethodsThis retrospective, cross-sectional study included all injured patients cared for in the resuscitation area of Khayelitsha Hospital’s emergency centre over a fourteen-week period. Injuries were coded using the Abbreviated Injury Scale, which was then used to estimate blood loss for each patient using an algorithm from the Trauma Audit Research Network. Descriptive statistics were used to describe blood volume lost and blood units required to replace losses greater than 15% circulating blood volume. Four units of emergency blood are stored in a dedicated blood fridge in the emergency centre. Platelets and fresh plasma are not available.ResultsA total of 389 injury events were enrolled of which 93 were excluded due to absent clinic data. The mean age was 29 (±10)?years. We estimated a median of one unit of blood requirement per week or weekend, up to a maximum of eight or six units, respectively. Most patients (n?=?275, 94%) did not have sufficient injury to warrant transfusion. Overall, one person would require a transfusion for every 15 persons with a moderate to serious injury.ConclusionThe volume of available emergency blood appears inadequate for injury care, and doesn’t consider the need for other causes of acute haemorrhage (e.g. gastric, gynaecological, etc.). Furthermore, lack of other blood components (i.e. plasma and platelets) presents a challenge in this low-resourced setting. Further research is required to determine the appropriate management of injury-associated haemorrhage from a resource and budget perspective.
机译：引言国际指南建议应使用血液制品恢复与损伤相关的出血性休克。然而，在低收入和中等收入国家，复苏强调使用晶体学-主要是由于血液产品获取不畅。这项研究旨在评估开普敦一家二级公共医院因可提供的紧急血液制品导致的严重伤害失血量。方法这项回顾性横断面研究纳入了Khayelitsha复苏区所护理的所有受伤患者医院的急诊中心为期十四周。使用简短伤害量表对伤害进行编码，然后使用创伤评估研究网络的算法将其用于估算每个患者的失血量。描述性统计数据用于描述失血量和补充大于15％循环血量的失血所需的血液单位。四个急诊血液储存在急救中心的专用血液冰箱中。结果未登记血小板和新鲜血浆。结果总共招募了389次损伤事件，其中93例由于缺乏临床数据而被排除在外。平均年龄为29（±10）？岁。我们估计每周或周末的平均血液需求量中位数为一，最多分别为八或六个单位。大多数患者（n = 275，94％）没有足够的损伤以致不能输血。总体而言，中度至重度伤害每15人需要输血一次。结论可用的紧急血液量似乎不足以进行伤害护理，并且不考虑需要其他引起急性出血的原因（例如，胃病，妇科病，等等。）。此外，在这种资源贫乏的环境中，缺乏其他血液成分（即血浆和血小板）提出了挑战。从资源和预算的角度来看，需要进一步的研究来确定与伤害相关的出血的适当管理。

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