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The Experience of a Level I Trauma Center in Israel

Dror Soffer, MD; Josef Klausner, MD; Dan Bar-Zohar, MD; Oded Szold, MD; Carl I. Schulman, MD, MSPH; Pinchas Halpern, MD; Avigail Shimonov, RN; Mara Hareuveni, PhD; Ofira Ben-Tal, MD

Arch Surg. 2008;143(10):983-989.

Objective  To predict how much blood will be needed based on the number of injured patients arriving after a multiple-casualty incident.

Design  A retrospective study evaluating data collected in 18 consecutive terrorist attacks in the city of Tel Aviv between January 1997 and February 2005.

Setting  A large, urban trauma center.

Patients  A total of 986 patients in 18 events.

Main Outcome Measures  Number of packed red blood cell (PRBC) units transfused per patient.

Results  A total of 332 U of PRBCs were transfused. Half of the PRBC units were administered as massive transfusions to 4.7% of the patients. The number of PRBC units transfused per patient index (PPI) was related to incident size (mean [SD], 0.70 [1.60] to 1.50  [1.60]). The most frequent major blood group transfused was type O (50%). Half of the units of PRBCs were supplied during the first 2 hours.

Conclusions  One unit of blood per evacuated victim is sufficient in a small multiple-casualty incident and 2 U is sufficient in a large multiple-casualty incident. Half of the PRBC units should be blood group O.

Author Affiliations: The Yitzhak Rabin Trauma Center and the Division of Surgery B, Tel Aviv Sourasky Medical Center (Drs Soffer, Bar-Zohar, and Szold and Ms Shimonov), Sackler Faculty of Medicine, University of Tel Aviv (Drs Soffer, Klausner, Bar-Zohar, Szold, Halpern, Shimonov, and Ben-Tal), and Division of Surgery, Tel Aviv Sourasky Medical Center (Drs Klausner and Halpern) Tel Aviv, Israel; Divisions of Burns, Trauma, and Critical Care, University of Miami Faculty of Medicine, Miami, Florida (Dr Schulman); and Blood Bank Laboratory, Tel Aviv Sourasky Medical Center (Drs Hareuveni and Ben-Tal).

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Arch Surg. 2008;143(10):989.
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