{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:07:05Z","timestamp":1747188425036,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Mortality rates, transfusion ratios, trauma management logistics, and assault characteristics from the El Paso mass shooting incident (MSI) are evaluated in comparison to other MSIs. In 2019, El Paso, TX experienced the eighth\u2010deadliest MSIs in modern US history. In this 21st mass killing in the United States of 2019, 19 people died immediately, and four of 27 injured, later died from ballistic injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We examined the victims' injuries, pre\u2010hospital treatments, transfusions, rotational thromboelastometry (ROTEM) interpretation, tranexamic acid (TXA) use, and compared El Paso's outcomes with other MSIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen casualties were treated for bullet injuries at University Medical Center (UMC). Three were in critical condition; one died during surgery. Of the remaining victims, two were guarded, and the remaining ten in stable condition. Anatomic trauma locations included chest, abdomen, hip, breast, thigh and arm. Haemostatic agents and TXA were administered to arriving patients. Seven casualties receiving blood products were administered 95\u2009units at UMC (45 red blood cells [RBC], 38 fresh frozen plasma [FFP], 8 platelets and 4 cryoprecipitate). ROTEM guided mass transfusion decisions in three patients. Out of seven MSIs reviewed, El Paso had the highest mortality rate (50.0%) and lowest RBC:FFP:admission ratio (1.18 at UMC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report the greatest proportion of transfusions per admission for an MSI and are first to discuss ROTEM roles to guide transfusion and manage coagulopathy during an MSI. This case highlights the severity and impact of MSIs on victims and requirements to follow established transfusion protocols with adjunct use of ROTEM, TXA and haemostatic agents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.13206","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T03:18:14Z","timestamp":1632453494000},"page":"299-312","source":"Crossref","is-referenced-by-count":2,"title":["Transfusion management of trauma from the 2019 El Paso mass shooting incident"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8348-4893","authenticated-orcid":false,"given":"Jesse","family":"Qiao","sequence":"first","affiliation":[{"name":"Department of Pathology Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center  El Paso TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradford","family":"Ray","sequence":"additional","affiliation":[{"name":"Patient Blood Management and Research University Medical Center  El Paso TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1715-7886","authenticated-orcid":false,"given":"Frank","family":"Wians","sequence":"additional","affiliation":[{"name":"Department of Pathology Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center  El Paso TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jude","family":"Abadie","sequence":"additional","affiliation":[{"name":"Department of Pathology Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center  El Paso TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,23]]},"reference":[{"key":"#cr-split#-e_1_2_7_2_1.1","unstructured":"Mass Shootings in the US Fast Facts.CNN editorial research [updated 2020 May 3"},{"key":"#cr-split#-e_1_2_7_2_1.2","unstructured":"cited 2020 June 6]. Available from:https:\/\/www.cnn.com\/2019\/08\/19\/us\/mass-shootings-fast-facts\/index.html"},{"key":"e_1_2_7_3_1","unstructured":"RomeroS FernandezM PadillaM.Massacre at a crowded Walmart in Texas leaves 2 dead.The New York Times 3 Aug 2019 [cited 2020 June 5]. Available from:https:\/\/www.nytimes.com\/2019\/8\/3\/us\/el-paso-shooting.html."},{"key":"e_1_2_7_4_1","unstructured":"World Health Organization.Mass casualty management systems: strategies and guidelines for building health sector capacity [cited 2020 June 5]. 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