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Method of Grant and Reeve for Estimating Blood Loss in Severe Injury

Purpose: To estimate blood loss following severe trauma based on the size of the wounds using the method of Grant and Reeve.

Description

Grant and Reeve used a rough measurement of a patient's injury to estimate blood loss. This is based on the number of the examiner's hands that can be used to cover each of the patient's wounds. While it was developed based on war wounds during World War II, it can be applied to severe civilian traumatic injury.


Wounds are separated into deep and superficial injuries. Deep wounds might include crush wounds or bullet wounds with small entrance holes.

 

Wound

Reference Size

deep

closed fist

surface

open hand

 

wound area in hands =

= (number of closed hands for deep wounds) + (number of open hands for surface wounds)

 

Number of Hands

Wound Classification

Blood Loss as Percent of Total Blood Volume

< 1

small

<= 10%, rarely > 20%

1 to < 3

moderate

20-40%

3 to < 5

large

40%

>= 5

very large

>=50%

 

Benefits:

(1) The method is fast and does not require special equipment.

(2) The wound size findings are fairly constant, while physiologic measurements like blood pressure may be affected by multiple factors.

 

Limitations:

• The method may underestimate blood loss with abdominal injuries.

• Examiners with differences in hand size might give different blood loss estimates (although this may not be significant since the estimates are somewhat crude).


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Specialty

Objective

ICD-10