AM20-82: Firearm Injuries in the United States: National Data and Evolution of the Transfusion Management Evidence Base

Description

The United States (US) leads all high income countries in gunshot wound (GSW) deaths. Gun violence takes numerous forms, contributing to suicides, homicides, unintentional deaths, law enforcement killings, as well as serious injuries, and affects individuals of all ages. It is undeniable that gun violence is a national health crisis. Firearm injuries are among the five leading causes of death for ages 1–64 years in USA and the second leading cause of death among US children and adolescents, after motor vehicular accidents. Transfusion Services at hospitals as well as blood centers play an integral role in management of these fatal/non-fatal events. This session aims to review the current National Data of GSW related visits in USA, the financial implications and evolution of the transfusion management over the decades. 

PROBLEM: Epidemiology of fatal and nonfatal firearm violence and blood utilization in the US: Across the spectrum from children to adults 

Speaker: Dr. Ruchika Goel 

• Review the national emergency room presentations, current national in-hospital demographics, in-hospital fatalities, and outcomes for firearms related injury in pediatric and adult patients in USA 
• To review the patterns of utilization of blood transfusions for various injury types, the economic burden of these visits and associated outcomes. 

TACTICS: Evolving role of transfusion medicine in treating GSW: What’s Hot, What’s Not 

Speaker: Dr. John R. Hess 

• Appraise the evolving evidence base and role of transfusion medicine in treating GSW. 
• Review GSW in one of America’s busiest trauma centers caring for children and adults, including the effects of putting blood on air and ground ambulances. 
• Review the changing blood bank response with new products/procedures such as Group A low-titer anti-B liquid plasma, whole blood, and giving platelets through high-speed blood injectors. 

STRATEGY: Impact of gun violence-related trauma on transfusion utilization and patient outcomes: All massive bleeding is not equal 

Speaker: Dr. Eric A. Gehrie

• Review available data on transfusion needs and outcomes for gun violence victims as compared to victims of other injuries. 
• Advance the argument that definitions of “massive transfusion” should be stratified to include the mechanism of injury leading to transfusion, not just the amount of blood lost.
  

Learning Objectives:

• Review the national emergency room presentations, current national in-hospital demographics, in-hospital fatalities, and outcomes for firearms related injury in pediatric and adult patients in USA.
• Appraise the evolving evidence base and role of transfusion medicine in treating GSW.
• Apply the argument that definitions of “massive transfusion” should be stratified to include the mechanism of injury leading to transfusion, not just the amount of blood lost.

Speaker(s):

• Dr. Eric A. Gehrie, MD, Medical Director of the Blood Bank, Refractor Health
• Dr. Ruchika Goel, MD, MPH, Johns Hopkins University School of Medicine
• Dr. John R. Hess, MD, Division of Transfusion Medicine, University of Washington

Disclosures

• Eric Gehrie, MD : Nothing to disclose
• Ruchika Goel, MD, MPH : Consultant: Terumo; Speakers Bureau: Alexion Pharamceuticals
• John Hess, MD : Consultant: Hermus Medical; Stockholder: Gele Lifesciences