• Dror Soffer, Josef Klausner, Dan Bar-Zohar, Oded Szold, Carl I Schulman, Pinchas Halpern, Avigail Shimonov, Mara Hareuveni, and Ofira Ben-Tal.
• The Yitzhak Rabin Trauma Center, Division of Surgery B, Tel Aviv Sourasky Medical Center, 6 Weizman St, 64239 Israel. sofferdror@hotmail.com
• Arch Surg. 2008 Oct 1; 143 (10): 983-9; discussion 989.

ObjectiveTo predict how much blood will be needed based on the number of injured patients arriving after a multiple-casualty incident.DesignA retrospective study evaluating data collected in 18 consecutive terrorist attacks in the city of Tel Aviv between January 1997 and February 2005.SettingA large, urban trauma center.PatientsA total of 986 patients in 18 events.Main Outcome MeasuresNumber of packed red blood cell (PRBC) units transfused per patient.ResultsA total of 332 U of PRBCs were transfused. Half of the PRBC units were administered as massive transfusions to 4.7% of the patients. The number of PRBC units transfused per patient index (PPI) was related to incident size (mean [SD], 0.70 [1.60] to 1.50 [1.60]). The most frequent major blood group transfused was type O (50%). Half of the units of PRBCs were supplied during the first 2 hours.ConclusionsOne unit of blood per evacuated victim is sufficient in a small multiple-casualty incident and 2 U is sufficient in a large multiple-casualty incident. Half of the PRBC units should be blood group O.

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