Case number | Patient details (age in years/sex) | Retrieval location | Clinical details | Provisional diagnosis | INR prior to transfer (POC or lab result) | CT prior to transfer | Clotting factor replacement prior to transfer | Hospital outcome | Thirty-day outcome |
---|---|---|---|---|---|---|---|---|---|
1 | 49/male | GPCH | Possible head injury 3 days prior. Presented with headache, vomiting, fixed, dilated right pupil and left-sided weakness. GCS 6/15 (E1V1M4). On warfarin for prosthetic heart valve | Intracranial haemorrhage | 4.6 (POC) | NA | PCC | Died | – |
2 | 79/female | RGH | Facial injury with expanding neck haematoma and difficulty opening mouth. On warfarin for AF | Airway compromise | 3.1 (Lab) | Yes | FFP | Survivor | Unknown |
3 | 68/female | RGH | Sudden onset headache and new dense left hemiparesis. GCS 9/15. On warfarin for AF | Intracranial haemorrhage | 3.0 (Lab) | Yes | PCC | Survivor | Survivor |
4 | 56/male | RGH | Road traffic collision causing haemothorax and multiple limb fractures. On warfarin; indication unknown | Major haemorrhage | 3.1 (Lab) | NA | PCC+FFP | Survivor | Survivor |
5 | 57/male | GPS | Significant head injury few weeks prior. Found collapsed in car. GCS 9/15. On warfarin for AF | Intracranial haemorrhage | NA | NA | Nil | Survivor | Survivor |
6 | 77/female | GPCH | Variceal bleed on background alcoholic liver disease and haemophilia B | Major haemorrhage | NA | NA | FFP | Survivor | Survivor |
AF, atrial fibrillation; CT, computed tomography; FFP, fresh frozen plasma; GPCH, General Practitioner-led Community Hospital; GPS, General Practitioner Surgery; GCS, Glasgow Coma Score; INR, International Normalized Ratio; Lab, Laboratory INR test; NA, Not available; PCC, Prothrombin complex concentrate; POC, Point-of-care INR test; RGH, Rural General Hospital.