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Blood and Blood Product Transfusion in Orthopedic Trauma: Clinical Practices and Optimization Strategies

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Editorial | Vol 12 | Issue 1 | January-June 2026 | page: 01-05 | Arvind Vatkar, Sachin Kale, Sumedha Shinde, Ashok Shyam

DOI: https://doi.org/10.13107/ti.2026.v12.i01.70

Submitted: 06/01/2026; Reviewed: 01/02/2026; Accepted: 05/03/2026; Published: 10/04/2026

Authors: Arvind Vatkar [1], Sachin Kale [2], Sumedha Shinde [3], Ashok Shyam [4]

[1] Department of Orthopaedics, MGM Medical College, Nerul, Navi Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, Dr. D.Y. Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India.
[3] Department of IHBT, Grant Government Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.
[4] Head of Research, Department of Orthopaedics, Sancheti Hospital, Pune, Maharashtra, India.

Address of Correspondence

Dr. Sachin Kale
Head of Unit, Department of Orthopaedics, Dr. D.Y. Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India.
Email: sachinkale@gmail.com

Editorial

Abstract

The immense and growing burden of orthopedic trauma in India, primarily due to road traffic accidents, necessitates a complete overhaul of blood management and clinical practices to achieve efficiency. Current practices are plagued by systemic inefficiencies, reflected in an orthopedic Cross-match to Transfusion Ratio (CTR) of 1.9. This habitual over-ordering unnecessarily depletes blood bank resources and escalates patient costs. The mandated evolution requires a transition from “anecdotal requisitioning”—ordering based on routine or habit—to robust, evidence-based protocols such as the Maximum Surgical Blood Ordering Schedule (MSBOS). Concurrent clinical strategies, including the prophylactic use of Tranexamic Acid (TXA) to safely reduce blood loss by up to 50% and the rigorous application of Venous Thromboembolism (VTE) prophylaxis, are fundamental. The successful implementation of these protocols will ensure the judicious use of precious resources, significantly enhance patient safety, and align surgical preparedness with documented clinical requirements.

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How to Cite this article: Vatkar A, Kale S, Shinde S, Shyam A | Blood and Blood Product Transfusion in Orthopedic Trauma: Clinical Practices and Optimization Strategies | January-June 2026; 12(1): 01-05 |

https://doi.org/10.13107/ti.2026.v12.i01.70

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The New Age of Trauma Resuscitation – Introducing Tranexamic Acid in an Accident & Emergency Department in Karachi Pakistan

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Vol 5 | Issue 1 | Jan-April 2019 | page: 10-13  |Muhammad Muzzammil, Muhammad Saeed Minhas, Jahanzeb Effendi, Syed Jahanzeb, Muhammad Ovais, Azeem Jamil, Ayesha Mughal, Abdul Qadir

Author: Muhammad Muzzammil[1], Muhammad Saeed Minhas[2], Jahanzeb Effendi[3],   Syed Jahanzeb[2], Muhammad Ovais[1], Azeem Jamil[2], Ayesha Mughal[2], Abdul Qadir[2]

1Department of Orthopedics, Dr. Ruth K M Pfau Civil Hospital , Karachi.
2Department of Orthopedics, Jinnah Post Graduate Medical Centre, Rafiqui Shaheed Road, Karachi.
3Department of surgery, MC 7742, San Antonio.

Address of Correspondence
Dr. Muhammad Muzamil,
Department of Orthopedics, Dr. Ruth K M Pfau Civil Hospital , Karachi.
Email: muzzammil_sangani@hotmail.com

Abstract

Background: In traumatic patients there is increase loss of blood and requires excessive blood transfusion as compared to other diseases. Clinical efficacy and clinical safety of tranexamic acid in decreasing blood loss assess during this study in post traumatic patients.
Method: Prospectively conducted randomized doubleblind placebo controlled study carried out. Patients were blindly randomized into two groups to receive either intravenous 1gm tranexamic acid 20 min or similar volume of 0.9% saline as placebo (P). Inclusion criteria was based on pulse rate >110 per min or systolic pressure level <90mmHg, hemorrhage or in danger of serious hemorrhage.Patients’ total blood loss was measured, needs of transfusion and hospital stay recorded. The post traumatic hemoglobin, hematocrit values, serum creatinine, activated thromboplastin time, prothombin time, platelets count and pulmonary embolism symptoms were comparatively evaluated.
Results: The total measured blood loss in tranexamic acid group (276 ± 53 mL) when comparing to control group (523 ± 74 mL) was less significantly. The requirement of blood transfusion in comparison was high in the control group and post traumatic hematocrit values were higher with in the tranexamic acid group. After administration of tranexamic acid in traumatic patients there have been no clinically relevant differences within the vital signs and no thromboembolic complications were detected in either group.
Conclusion: In traumatic patients, the prophylactic usage of tranexamic acid has effectively decreased blood loss, transfusion needs and hospital stay without any complication or adverse effects of thrombosis. Thus, TXA can be used safely and effectively in trauma subjects.
Keywords: trauma, tranexamic acid, blood loss, transfusion, hospital stay.

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How to Cite this article:  Muzzammil M, Minhas M S, Effendi J, Jahanzeb S, Ovais M, Jamil A, Mughal A, Qadir A. The New Age of Trauma Resuscitation – Introducing Tranexamic Acid in an Accident & Emergency Department in Karachi Pakistan. Trauma International Jan-April 2019;5(1):10-13.

 


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