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Estimation of External Blood Loss by Paramedics: Is There Any Point?

Published online by Cambridge University Press:  28 June 2012

Brett Williams  and
Mal Boyle
Brett Williams*
Affiliation:
Monash University, Department of Community Emergency Health and Paramedic Practice, Frankston, Victoria, Australia
Mal Boyle
Affiliation:
Monash University, Department of Community Emergency Health and Paramedic Practice, Frankston, Victoria, Australia
*
Brett Williams Monash University Department of Community Emergency Health and Paramedic Practice, Building H McMahons Rd. Frankston 3199 Victoria, Australia E-mail: [email protected]
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Abstract

Objectives:

There are many patient assessment challenges in the prehospital setting, especially the estimation of external blood loss. Previous studies of experienced paramedics have demonstrated that external blood loss estimation is highly inaccurate. The objective of this study was to determine if undergraduate paramedic students could accurately estimate external blood loss on four surfaces commonly found in the prehospital environment.

Methods:

This prospective, observational, blinded study used a convenience sample of undergraduate students studying at Monash University during 2006. Students were provided with four clinical vignettes using four different surfaces and varying simulated blood amounts.

Results:

Accurate estimation occurred with the vinyl simulation (100 ml), with a mean value of the estimations of 98 ml (95% Confidence Interval (CI) 84–113 ml). Carpet and concrete surfaces were both associated with large under-estimations.The carpet simulation (1,000 ml) had a mean value for the estimations of 347 ml (95% CI 320–429 ml). The concrete simulation (1,500 ml) had a mean value for the estimations of 885ml (95% CI 771–999 ml). Conversely, the clothing simulation (500 ml) emphasized over-estimation, with a mean value for the estimations of 1,253 ml (95% CI 1,093–1,414 ml). There was no relationship between increased accuracy and clinical experience, exposure, educational qualifications, or age of students.

Conclusions:

External blood loss estimation by undergraduate paramedic students generally is too inaccurate to be of any clinical benefit. Particularly, absorbent and impermeable surfaces precipitated inaccuracies by undergraduate paramedic students.

Keywords

ambulancesblood lossemergency medical servicesemergency medical techniciansparamedicprehospital care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 6 , December 2007 , pp. 502 - 506
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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References

1.Moscati, R, Billittier, A, Marshall, B, Fincher, M, Jehle, D, Braen, R: Blood loss estimation by out-of-hospital emergency care providers. Prehosp Emerg Care 1999;3(3):239–242.CrossRefGoogle ScholarPubMed
2.Victorino, GP, Battistella, FD, Wisner, DH: Does tachycardia correlate with hypotension after trauma? J Am Coll Surg 2003;196(5):679–684.CrossRefGoogle ScholarPubMed
3.Patton, K, Funk, D, McErlean, M, Bartfield, J: Accuracy of estimation of external blood loss by EMS personnel. J Trauma 2001;50(5):914–916.CrossRefGoogle ScholarPubMed
4.Tall, G, Wise, D, Grove, P, Wilkinson, C: The accuracy of external blood loss estimation by ambulance and hospital personnel. Emerg Med 2003;15(4):318–321.CrossRefGoogle ScholarPubMed
5.Dildy, GA 3rd, Paine, AR, George, NC, Velasco, C: Estimating blood loss: Can teaching significantly improve visual estimation? Obstet Gynecol 2004;104(3):601–606.CrossRefGoogle ScholarPubMed
6.Duthie, S, Gordon, D, Guang, D, Chan, S, Ma, H: Discrepancy between laboratory determination and visual estimation of blood loss during normal delivery. Eur J Obstet Gynecol Reprod Biol 1990;38(2):119–124.CrossRefGoogle Scholar
7.Higgins, G. Measuring nurses' accuracy of estimating blood loss. J Adv Nurs 1982;7(2):157–162.CrossRefGoogle ScholarPubMed
8.Razvi, K, Chua, S, Arulkumaran, S, Ratnam, SS: A comparison between visual estimation and laboratory determination of blood loss during the third stage of labour. Aust N Z J Obstet Gynaecol 1996;36(2):152–154.CrossRefGoogle ScholarPubMed
9.Coronial Communique: Blood Loss Estimation: How Accurate? Melbourne: State Coroner Victoria 2006.Google Scholar
10.Beer, H, Duvvi, S, Webb, C., Tandon, S: Blood loss estimation in epistaxis scenarios. J Laryngol Otol 2005;119(1):16–18.CrossRefGoogle ScholarPubMed
11.Little, RA, Kirkman, E, Driscoll, P, Hanson, J, Mackway-Jones, K: Preventable deaths after injury: Why are the traditional “vital” signs poor indicators of blood loss? J Accid Emerg Med 1995;12(1):1–14.CrossRefGoogle ScholarPubMed