Recent clinical trials have firmly established the relationship between transfusion ratios and survival. But during a fast-paced trauma resuscitation, keeping track of blood components and monitoring crystalloid volumes is a major logistical challenge. A new device called the MTP Scorekeeper™ automatically tracks transfusion ratios and displays them clearly to the entire trauma team.
The MTP Scorekeeper is currently being evaluated for clinical use by the FDA. The device was invented by Alex Guerrero, MD, FACS, a trauma surgeon who has seen trauma teams struggle to develop an effective way to manage massive transfusion protocols.
“We know that getting the right transfusion ratios improves survival for rapidly bleeding patients,” Dr. Guerrero said. “We also know that massive transfusions are a logistical nightmare. They often take place in the middle of the night, they require a lot of coordination with the blood bank, and they occur at the most chaotic time when team members are distracted by other tasks and the team leader is focused on surgically managing hemorrhage.”
“The MTP Scorekeeper helps trauma teams monitor and manage the process better since the transfusion ratios are prominently visible to the entire room,” he said.
The challenge of tracking transfusion ratios
For the last several years, trauma programs have worked hard to establish effective MTPs. The focus is typically on initiating the protocol early; choreographing the movement of blood products from the blood bank to the trauma bay, OR or ICU; and accurately documenting what blood products were administered. But even when the logistics are in place, trauma leaders still face the challenge of monitoring actual transfusion ratios and limiting crystalloid administration in real time.
“As we all know, blood products are available at different times. Staff often lose track of how many RBC and plasma units were hung, while things like cryoprecipitate might be forgotten altogether,” Dr. Guerrero said. “On top of that, you have to take into account any products that were given pre-hospital.”
Trauma teams have tried several ways to keep track of transfusion ratios, but all of them have significant drawbacks.
“Some teams have tried to track ratios on a dry erase board. The problem is that the whiteboard can’t follow the patient if you go to the OR and ICU,” Dr. Guerrero said. “You can try a smaller board, but then it’s too small for everyone to see.”
Another option is to track ratios using the EMR. “The issue there is that the information isn’t available to the entire team, and the pre-hospital products are not included,” he said.
To administer massive transfusions effectively, trauma leaders need a system that requires little human management, can travel with a patient and provides critical information to the entire trauma team.
An elegant solution for massive transfusions
The MTP Scorekeeper clearly displays the amount of blood products administered and the volume of crystalloids given. This gives trauma team leaders an easy, intuitive way to keep track of infusion ratios.
The MTP Scorekeeper attaches to any rapid infuser device. Its large display looks like a lighted scoreboard. Water-resistant toggle switches allow staff to easily keep track of transfusion units for each of the following categories:
- Packed red blood cells (PRBCs)
- Fresh frozen plasma (FFP)
The device is battery-powered and portable, so it can roll with the rapid infuser to follow the patient from the trauma bay to the OR and the ICU.
“Maintaining 1:1:1 or 1:1:2 while limiting crystalloids is a real challenge when you are in the middle of everything else,” Dr. Guerrero said. “The benefit of the MTP Scorekeeper is that no matter what’s going on, you can look over any time and see what the transfusion ratios are. This way you can keep the MTP on the right course, even when your hands are packing a bad liver injury.”
“We know that modern transfusion strategy improves outcomes, and we also know that hospitals have a difficult time reaching the ideal ratios, sometimes wasting blood products,” Dr. Guerrero said. The MTP Scorekeeper has the potential to improve outcomes and give exactly what is recommended by best practices. “While that remains to be proven, one thing is certain — the MTP Scorekeeper solves the big headache of keeping track of transfusion ratios, which for a surgeon and team leader is worth its weight in gold.”
The MTP Scorekeeper is currently in development by Trauma Ready, a trauma care optimization and innovation company. The company is seeking funding to fulfill final regulatory requirements and bring the device to market.
“Funding is critical to getting the MTP Scorekeeper in the hands of users,” Dr. Guerrero said. “The funds will be used to register this tool with the FDA as a Class I medical device. Funding will also be used for clinical use design and the creation of a quality improvement infrastructure.”
As a key part of its funding strategy, Trauma Ready is seeking angel investors within the trauma community itself. Trauma physicians and others who are interested in the MTP Scorekeeper have the opportunity to invest in the commercialization of this device.
“We’re excited to offer this opportunity to trauma surgeons and other trauma leaders, because we feel it’s a natural fit,” Dr. Guerrero said. “A lot of people have been waiting for a device like this, and investing in its development is a great way to help bring it to market and be part of something that is important for our specialty.”
To learn more about opportunities to invest in the MTP Scorekeeper, click here to email Alex Guerrero, MD, FACS.