Exploration of patient blood management metrics for emergency departments: a 4-year retrospective monocenter study

Comprehensive Summary

This study in BMC Emergency Medicine evaluated red blood cell (RBC) transfusion practices in the ED to develop a metric of transfusion efficiency. At a French university hospital (2020–2023), the authors calculated the Yearly Adjusted Number of Transfusions per ED-patient (YANTED), which excluded low-acuity visits from the denominator. Over the 4-year period, 5,537 units of RBCs were transfused. The median YANTED was 16.3 units per 1,000 ED patients, with relative emergencies accounting for 67% of transfusions. Median time from order to transfusion was 182 minutes; only 23% of urgent cases met the 30-minute target. These ED RBC transfusions represented 11% of the total RBC usage in the hospital. ​​The YANTED metric provided an overview of ED transfusion activity and highlighted delays in initiation as a key area for improvement.

Outcomes and Implications

RBC transfusion is often lifesaving, and optimizing ED processes can improve patient outcomes. ED transfusions are time-critical, requiring coordinated care. Delays risk worsening hemorrhage, shock, and poor outcomes. Increased efficiency in RBC transfusions in the ED would ultimately lead to better patient outcomes in emergent situations.