Chest trauma is common in trauma patients. Chest tubes are required with some regularity for the management of hemothorax and/or pneumothorax. Occasionally, the amount of blood in the chest is substantial, and when the tube goes in we wish that we were able to transfuse that blood.
Well, you can! Most collection systems have optional autotransfusion canisters that connect to the chest tube inline with the collection system. The canisters are used to collect shed blood and can then be hung like a bag of blood from the blood bank.
A few key points about using autotransfusion canisters:
- I recommend you consider it for any chest tube being inserted for trauma. They will almost always have some blood in their chest.
- If you want to limit use further due to the expense, just add it for trauma activation patients.
- Always add it to the chest tube collection system before the chest tube goes in. Most of the blood will be lost if the chest tube is hooked to the collection system first.
- No need to anticoagulate the blood. Most systems can be used to reinfuse shed blood up to 6 hours after collection without heparin or other products.
- Be sure to use an inline blood filter. There will be some debris and clumps that must be removed.
- Don’t use the blood if it is likely to be contaminated. This most often occurs with penetrating trauma, where a stab or gunshot could injure stomach or colon and violate the diaphragm.
- Follow the manufacturer’s instructions for your brand of collection system.
Here’s a picture of an autotransfuser that attaches to a Pleur-Evac brand system.