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Journal ArticleDOI

Identifying risk for massive transfusion in the relatively normotensive patient: utility of the prehospital shock index.

TLDR
Prehospital SI>0.9 identifies patients at risk for MT who would otherwise be considered relatively normotensive under current prehospital triage protocols, and the risk forMT rises substantially with elevation of SI above this level.
Abstract
Background:In the prehospital environment, the failure of medical providers to recognize latent physiologic derangement in patients with compensated shock may risk undertriage. We hypothesized that the shock index (SI; heart rate divided by systolic blood pressure [SBP]), when used in the prehospita

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Citations
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Journal ArticleDOI

The Shock Index revisited – a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU®

TL;DR: SI upon emergency department arrival may be considered a clinical indicator of hypovolemic shock in respect to transfusion requirements, hemostatic resuscitation and mortality and the four SI groups have been shown to equal the recently suggested BD-based classification.

Serum Lactate and Base Deficit as Predictors of Mortality in Normotensive Elderly Blunt Trauma Patients

TL;DR: Both lactate and BD were associated with significantly increased mortality in normotensive elderly blunt trauma patients and, because of the high baseline mortality rates in elderly trauma patients, "normal" lactate does not offer complete reassurance to the clinician.
Journal ArticleDOI

A Systematic Review of the Relationship between Blood Loss and Clinical Signs

TL;DR: A substantial variability in the relationship between blood loss and clinical signs is found, making it difficult to establish specific cut-off points for clinical signs that could be used as triggers for clinical interventions, but the shock index can be an accurate indicator of compensatory changes in the cardiovascular system due to blood loss.
Journal ArticleDOI

Pediatric specific shock index accurately identifies severely injured children.

TL;DR: A pediatric specific shock index (SIPA) more accurately identifies children who are most severely injured, have intraabdominal injury requiring transfusion, and are at highest risk of death when compared to shock index unadjusted for age.
References
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Journal ArticleDOI

Early Prediction of Massive Transfusion in Trauma: Simple as ABC (Assessment of Blood Consumption)?

TL;DR: The ABC score, which uses nonlaboratory, nonweighted parameters, is a simple and accurate in identifying patients who will require MT as compared with those previously published scores.
Journal ArticleDOI

Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening hemorrhage after multiple trauma.

TL;DR: In this paper, a simple scoring system that allows an early and reliable estimation for the probability of mass transfusion (MT) as a surrogate for life threatening hemorrhage following multiple trauma was developed.
Journal ArticleDOI

Serum lactate and base deficit as predictors of mortality and morbidity.

TL;DR: Elevated initial and 24-hour lactate levels are significantly correlated with mortality and appear to be superior to corresponding base deficit levels.
Journal ArticleDOI

A Comparison of the Shock Index and Conventional Vital Signs to Identify Acute, Critical Illness in the Emergency Department

TL;DR: The SI may be useful to evaluate acute critical illness in the ED with apparently stable vital signs and an abnormal elevation of the SI to more than 0.9 was associated with an illness that was treated immediately, admission to the hospital, and intensive therapy on admission.
Journal ArticleDOI

Resuscitation of the critically III in the ED: Responses of blood pressure, heart rate, shock index, central venous oxygen saturation, and lactate

TL;DR: It was concluded that additional therapy is required in the majority of critically ill patients to restore adequate systemic oxygenation after initial resuscitation and hemodynamic stabilization in the ED and the measurement of ScvO2 and Lact can be utilized to guide this phase of additional therapy in theED.
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