Surgical Critical Care Initiative (SC2i) develops Mobile App to Predict Massive Transfusion Need

By SC2i
Edited by Zachary Willis

According to the American College of Surgeons, “hemorrhage is the most common cause of death within the first hour of arrival” to a trauma center. Nearly half of all deaths in the first 24 hours following traumatic injury and more than 80 percent of operating room fatalities are because the patient has bled to death. Only a small percentage of trauma patients receive blood transfusions, but those few consume nearly three-fourths of the center’s transfusion blood supply. Massive transfusion protocols (MTPs) have been developed and put into place to help guide appropriate use of blood supplies while saving lives.

A clinical provider uses the massive transfusion protocol mobile
app to determine whether or not a trauma patient just admitted
to the emergency room requires a massive blood transfusion.
(Photo Courtesy of SC2i)

When approaching traumatically injured patients, effective decision-making is necessary, especially around the activation of an institution’s MTP. Implementing this type of protocol can be a significant commitment of resources, which tend to already be relatively scarce, both in terms of personnel and material. Bedside clinicians are generally faced with this critical decision equipped with little more than some basic data points, and their own experience and clinical judgment.

The Uniformed Services University of the Health Sciences (USU) Surgical Critical Care Initiative (SC2i) has created a statistically powerful and accurate mobile application as a result of this scarcity of materials and data that can assist a clinician in this life-saving decision.

Previously published scoring systems – methods of using variables of the patient’s condition to determine the best course of action – are of little use at the bedside as they are either overly simplistic (and therefore not sufficiently accurate) or are too complicated for ease of use.

This mobile app allows for the accurate prediction of massive transfusion based on a sophisticated statistical model created using admission variables readily available to the clinician at the bedside. The MTP app has been validated on a cohort of 363 patients and was recently turned into a Fast Healthcare Interoperability Resources-enabled clinical decision support tool to allow for seamless insertion into today’s electronic health records.

The Massive Transfusion Protocol mobile application developed by the Uniformed Services University’s SC2i used by academic partner Emory University/Grady Memorial Hospital uses simple clinical variables like heart rate, and blood pressure to support decision making. (Image Courtesy of SC2i)

The SC2i is currently working to deploy the mobile app in treatment facilities throughout the military health system and in partner with civilian academic health centers, like Duke University in North Carolina, and Emory University’s Grady Memorial Hospital in Atlanta, throughout the country to further validate its clinical utility.

“The MTP mobile app developed by the USU SC2i will ensure the right patients receive damage control resuscitation, leading to improvements in clinical outcomes and resource utilization,” says Navy Capt. (Dr.) Eric Elster, professor and chair of the USU-Walter Reed National Military Medical Center Department of Surgery.