13% of injured normotensive patients arriving in emergency unit need mass blood-transfusion of six or more units of packed Red Blood Cells. It is currently difficult to predict the need for such a mass blood-transfusion. Indeed hemoglobin point of care testing (hemocue) and blood pressure can be normal during the first hours despite intensive bleeding. It's well known that blood or arterial lactate measures correlate with trauma severity but these measures are not available in a pre-hospital setting. The investigators want to test whether capillary lactate measures also correlate with trauma severity and can therefore predicts earlier transfusion needs.
Study Type
OBSERVATIONAL
Enrollment
120
Use of capillary sample to determine lactate level upon arrival at vital emergency unit and at 2 hours
Grenoble University Hospital
La Tronche, Isere, France
Transfusion of 6 or more units of packed Red Blood Cells (RBC)
Time frame: 48 hours
arterial lactate measures
Time frame: upon arrival at the vital emergency unit
injury scores (ISS,SOFA)
Time frame: 24h
transfusion of 4 units of packed RBC
Time frame: 48 hours
blood lactate measure
Time frame: upon arrival at vital emergency unit
Intensity of medical care
Body scan Central venous catheterisation arterial catheterisation
Time frame: upon arrival at vital emergency unit
Bleeding Predictive Score
3 questions are asked to the doctor in emergency room. Could patient be admitted directly at the CT scan ? Do you think that the patient need transfusion ? If Yes : and how many units ? Do you think that the patient will be hospitalized in an intensive care unit after the emergency room?
Time frame: upon arrival at vital emergency unit
Mortality
Time frame: 28 days
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