{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:51Z","timestamp":1787017011086,"version":"build-2736575974"},"reference-count":17,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2018,8,14]]},"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Uncrossmatched packed red blood cell (PRBC) transfusion is fundamental in resuscitation of hemorrhagic shock. Ready availability of uncrossmatched blood can be achieved by storing uncrossmatched blood in a blood bank refrigerator in the emergency department (ED), but could theoretically lead to inappropriate uncrossmatched use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study was performed at a level I trauma center from January 2013 to March 2014. Possibly inappropriate transfusion was defined as patients who received at least one unit of blood from the ED refrigerator and no more than two units of PRBC in the first 24 hours. Deaths within the first 24\u2009hours were excluded. Patients who received blood from the ED refrigerator who received \u22642 units total in 24\u2009hours were compared with those who received &gt;2 units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>158 adults received blood from the ED refrigerator. 140 (88.6%) were trauma patients. 37 (23.4%) received massive transfusion (MT). 42 (26.6%) deaths were excluded. 29 patients received \u22642 units and 87 received &gt;2 units in the first 24 \u2009hours. The \u22642 units group had a higher systolic blood pressure (116 \u2009mm Hg vs. 102 \u2009mm Hg, p=0.042), lower base deficit (6.4 mEq\/L vs. 9.4 mEq\/L, p=0.032), higher hematocrit (34% vs. 30%, p=0.024), lower rate of MT protocol activation (27.6% vs. 58.6%, p=0.005), and lower rates of transfusion of fresh frozen plasma (17.2% vs. 54.0%, p=0.001) and platelets (13.8% vs. 39.1%, p=0.012). Appropriately transfused patients were more likely to have evidence of shock with active, non-compressible hemorrhage. Potentially inappropriate uses were more likely in patients either without evidence of hemorrhage or without signs of shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Storing uncrossmatched blood in the ED is an effective way to get PRBCs transfused quickly in hemorrhaging patients and is associated with a low rate of unnecessary uncrossmatched transfusion. Provider education and good clinical judgment are imperative to prevent unnecessary use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level III, therapeutic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tsaco-2018-000184","type":"journal-article","created":{"date-parts":[[2018,10,10]],"date-time":"2018-10-10T01:36:19Z","timestamp":1539135379000},"page":"e000184","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Experience with uncrossmatched blood refrigerator in emergency department"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7132-1854","authenticated-orcid":false,"given":"Charles T","family":"Harris","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Totten","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Davenport","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Kansas, Lawrence, Kansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky, 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