From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Blood Transfusion Studies?
Date: 19 Jan 1998 19:00:39 GMT

In <34c544b4.6329447@news.couriernet.infi.net>
<kiminy@couriernet.infi.net> (Pete.) writes:
>
>On Sun, 18 Jan 1998 14:46:53 -0800, "Daniel Giaimo"
><rgiaimo@nospam.ix.netcom.com> wrote:
>
>>    Are there any double-blind studies on the effectiveness of blood
>>transfusions in critical injury cases? I can't seem to find any on the
>>internet using either the lycos or the yahoo search engines.
>
>	I'm not sure what criteria you are looking for, but my
>experience working in a blood bank is that, yes, packed red cell
>transfusions *do* save lives in critical injury cases. Lack of oxygen
>and low blood pressure leading to shock are two complications that
>lead to death if they are not treated with transfusions. I personally
>was directly involved in a case where a 15 year-old girl had severe
>internal injuries, and required an emergency radical nephrectomy. We
>put 23 units of blood into her in a two hour period, which is more
>that twice her blood volume. She lived. Transfusions work.
>
>Pete Womack, MT(ASCP).


   On the other hand, transfusion in the field is another matter,
unless you can give warmed, whole, converted blood.  When people
hemorrhage their remaining blood runs slower, gets thick, and their
pressure falls.  All this is good for slowing the loss.  Expand what's
left with crystaloid or plasmanate or anything that doesn't have
platelets and clotting factors in it, and you may not do them a
service.  In fact, you may just encourage them to bleed out what's left
of their oxygen carrying capacity.  People (especially young people
with pentrating trauma) tolerate shock and low BPs for a surprisingly
long time (the golden hour), so long as not in actual arrest.  During
that time, it may be better just to scoop and run.  Studies are
ongoing.


                                          Steve Harris, M.D.