The Cardiovascular
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ABC score for massive transfusion

Predicts need for massive transfusion in trauma.

ABC score for massive transfusion
Penetrating mechanism of injury
Emergency department systolic BP <=90 mmHg
Emergency department heart rate >=120 /min
Positive focused assessment with sonography for trauma (FAST)
Result0 points

Score <2 makes massive transfusion unlikely.

Massive transfusion predicted
No

When to use

  • Rapidly deciding whether to activate a massive transfusion protocol in adult trauma.

Formula

One point each: penetrating mechanism, SBP <=90, HR >=120, positive FAST. A total >=2 is a positive screen.

Pearls and pitfalls

  • Uses only bedside variables available before laboratory results.
  • Sensitivity is imperfect; clinical judgement still governs activation.

References

  1. Nunez TC, et al. J Trauma. 2009;66(2):346-352.