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. 2012 Sep;13(4):376-9.
doi: 10.5811/westjem.2011.9.6669.

Emergency physician estimation of blood loss

Jeffery C Ashburn, Tamara Harrison, James J Ham, Jared Strote

Emergency physician estimation of blood loss

Jeffery C Ashburn et al. West J Emerg Med. 2012 Sep.

Abstract

Introduction: Emergency physicians (EP) frequently estimate blood loss, which can have implications for clinical care. The objectives of this study were to examine EP accuracy in estimating blood loss on different surfaces and compare attending physician and resident performance.

Methods: A sample of 56 emergency department (ED) physicians (30 attending physicians and 26 residents) were asked to estimate the amount of moulage blood present in 4 scenarios: 500 mL spilled onto an ED cot; 25 mL spilled onto a 10-pack of 4 × 4-inch gauze; 100 mL on a T-shirt; and 150 mL in a commode filled with water. Standard estimate error (the absolute value of (estimated volume - actual volume)/actual volume × 100) was calculated for each estimate.

Results: The mean standard error for all estimates was 116% with a range of 0% to 1233%. Only 8% of estimates were within 20% of the true value. Estimates were most accurate for the sheet scenario and worst for the commode scenario. Residents and attending physicians did not perform significantly differently (P > 0.05).

Conclusion: Emergency department physicians do not estimate blood loss well in a variety of scenarios. Such estimates could potentially be misleading if used in clinical decision making. Clinical experience does not appear to improve estimation ability in this limited study.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding, sources, and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

References

    1. Brant HA. Precise estimation of postpartum haemorrhage: difficulties and importance. Br Med J. 1967;1:398–400. - PMC - PubMed
    1. Duthie SJ, Ven D, Yung GL, et al. Discrepancy between laboratory determination and visual estimation of blood loss during normal delivery. Eur J Obstet Gynecol Reprod Biol. 1991;38:119–124. - PubMed
    1. Larsson C, Saltvedt S, Wiklund I, et al. Estimation of blood loss after cesarean section and vaginal delivery has low validity with a tendency to exaggeration. Acta Obstet Gynecol Scand. 2006;85:1448–1452. - PubMed
    1. Meiser A, Casagranda O, Skipka G, et al. Quantification of blood loss. How precise is visual estimation and what does its accuracy depend on. Anaesthesist. 2001;50:13–20. [article in German]? - PubMed
    1. Moscati R, Billittier AJ, Marshall B, et al. Blood loss estimation by out-of-hospital emergency care providers. Prehosp Emerg Care. 1999;3:239–242. - PubMed