An audit of fluid resuscitation practice in trauma patients with mmajor haemorrhage at Christchurch Hospital.


Journal

The New Zealand medical journal
ISSN: 1175-8716
Titre abrégé: N Z Med J
Pays: New Zealand
ID NLM: 0401067

Informations de publication

Date de publication:
20 11 2020
Historique:
entrez: 23 11 2020
pubmed: 24 11 2020
medline: 15 12 2020
Statut: epublish

Résumé

Damage control resuscitation with limited crystalloids and early use of blood products is now considered standard care in major trauma. The purpose of this study was to audit resuscitation practice in trauma patients where a massive transfusion protocol (MTP) had been activated, to determine whether crystalloid administration and adherence to the MTP had improved since an audit and education sessions in July 2017. We conducted a retrospective study looking at trauma patients presenting to Christchurch Hospital who had a MTP activated form the 1 May 2016 to 1 March 2019. Patients were identified by cross-referencing the trauma call database with the electronic transfusion registry. Thirty-four patients were included in the audit. There was no significant difference in mean crystalloid administration before and after July 2017 (5.74 litres and 4.86 litres respectively). Patients presenting before July 2017 received a significantly lower mean fresh frozen plasma to red blood cells (FFP:RBC) compared to patients after July 2017. Trauma patients with major haemorrhage at Christchurch Hospital are still receiving excess crystalloids; however, our audit suggests that compliance with the MTP has improved. Further education involving the entire trauma team is required to improve fluid resuscitation practice.

Identifiants

pubmed: 33223544

Substances chimiques

Crystalloid Solutions 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

11-17

Déclaration de conflit d'intérêts

Nil.

Auteurs

Calan Jones (C)

Emergency Medicine Registrar, Canterbury District Health Board, Christchurch.

Bianca Wadham (B)

Core Surgical Trainee Level 2, General Surgery, Wythenshawe Hospital, Manchester, England.

Wayne Morriss (W)

Clinical Senior Lecturer University of Otago and Consultant Anaesthetist, Canterbury District Health Board, Christchurch.

Andrew McCombie (A)

Research Officer and Data Analyst, Department of Surgery, Canterbury District Health Board, Christchurch.

Melissa Evans (M)

Trauma Nurse Coordinator, Department of Surgery, Canterbury District Health Board, Christchurch.

Christopher Wakeman (C)

Senior Lecturer University of Otago and General Surgeon, Canterbury District Health Board, Christchurch.

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Classifications MeSH