Objective: To determine if emergency personnel, either ambulance or hospital based, can estimate the volume of external blood loss accurately enough to be of potential clinical use in guiding fluid resuscitation. Methods: A total of 61 ambulance and 35 hospital personnel viewed nine scenarios consisting of volumes of blood (100 mL, 400 mL and 700 mL) spilt onto three surfaces — carpet, vinyl and a clothed manikin. They were asked to estimate the blood loss in each case. Results: Estimates of volumes of blood loss on all surfaces were generally inaccurate. Both ambulance and hospital groups were comparable in this regard. Hospital personnel had higher mean estimates than those of ambulance personnel. Of particular clinical relevance were the findings that blood loss on carpet was underestimated and small volumes on a clothed manikin were overestimated. Conclusion: External blood loss estimation by ambulance and hospital personnel is generally too inaccurate to be of clinical use.

The introduction of TCM improved the efficiency and effectiveness of trauma patient care in our institution.