Abstract
Background: Modern publications on response to single explosive events are from non-US hospitals, predate current resuscitation guidelines and lack detail on surgical and intensive care unit (ICU) requirements. The objective of this study is to provide a contemporary account of surge response to multiple casualty incidences following explosive events managed at a US trauma hospital in Iraq. Methods: Observational study and retrospective chart review of 72-hour transfusion, operating room, and ICU resource utilization from 3 multiple casualty incidences managed at the US Air Force Theater Hospital, Balad AB, Iraq between February and April 2008. Results: Fifty patients were treated with a mean injury severity score of 19. Forty-eight percent (n = 24) of casualties required blood transfusion with 4 pat ents receiving 43% (N = 74 units) of the packed red blood cells (pRBC). An average of 3.5 and 3.8 units of pRBC and plasma, respectively, was transfused per casualty (pRBC:plasma ratio of 1:1.1). Seventy-six percent (n = 38) of patients required immediate operation upon initial presentation. A total of 191 procedures were performed in parallel during 75 operations (3.8 procedures per casualty). Fifty percent (n = 25) of patients required ICU admission with nearly the same number (n = 24) requiring mechanical ventilator support beyond that required for operation. All cause, in-hospital mortality was 8% (n = 4). Conclusions: Results from this study provide a contemporary assessment of transfusion, surgical, and intensive care resource requirements after a single explosive event. Data from this experience may translate into useful guidelines for emergency planners worldwide.
Original language | English |
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Pages (from-to) | 311-315 |
Number of pages | 5 |
Journal | Annals of surgery |
Volume | 250 |
Issue number | 2 |
DOIs | |
State | Published - Aug 2009 |
Externally published | Yes |
Keywords
- Explosive devices
- Mass casualty
- Transfusion
- Trauma surgery