Emergency use of prethawed Group A plasma in trauma patients

Zielinski, Martin D.; Johnson, Pamela M.; Jenkins, Donald H.; Goussous, Naeem; Stubbs, James R.

doi:10.1097/ta.0b013e3182788f8e

Cited by 62 publications

(62 citation statements)

References 27 publications

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“…A review of all trauma patients receiving emergency group A plasma transfusions from 2008 to 2011 was recently conducted at our institution (8). Of 254 patients, 219 (86%) received ABO-compatible plasma, and 35 (14%) received ABO-incompatible plasma.…”

Section: Blood Bank Background At Mayo Clinicmentioning

confidence: 99%

Implementation and Execution of Civilian Remote Damage Control Resuscitation Programs

Jenkins¹,

Stubbs

Williams

et al. 2014

Shock

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Remote damage control resuscitation is a recently defined term used to describe techniques and strategies to provide hemostatic resuscitation to injured patients in the prehospital setting. In the civilian setting, unlike the typical military setting, patients who require treatment for hemorrhage come in all ages with all types of comorbidities and have bleeding that may be non-trauma related. Thus, in the austere setting, addressing the needs of the patient is no less challenging than in the military environment, albeit the caregivers are typically not putting their lives at risk to provide such care. Two organizations have pioneered remote damage control resuscitation in the civilian environment: Mayo Clinic and Royal Caribbean Cruises Ltd. The limitations in rural Minnesota and shipboard are daunting. Patients who have hemorrhage requiring transfusion are often hundreds of miles from hospitals able to provide damage control resuscitation. This article details the development and implementation of novel programs specifically designed to address the varied needs of patients in such circumstances. The Mayo Clinic program essentially takes a standard-of-care treatment algorithm, by which the patient would be treated in the emergency department or trauma bay, and projects that forward into the rural environment with specially trained prehospital personnel and special resources. Royal Caribbean Cruises Ltd has adapted a traditional military field practice of transfusing warm fresh whole blood, adding significant safety measures not yet reported on the battlefield (see within this Supplement the article entitled "Emergency Whole Blood Use in the Field: A Simplified Protocol for Collection and Transfusion"). The details of development, implementation, and preliminary results of these two civilian programs are described herein.

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Section: Blood Bank Background At Mayo Clinicmentioning

confidence: 99%

Implementation and Execution of Civilian Remote Damage Control Resuscitation Programs

Jenkins¹,

Stubbs

Williams

et al. 2014

Shock

Self Cite

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“…The rationale for frozen plasma rather than prethawed plasma is the relative scarcity (approximately 1%) of US donors with type AB and no previous transfusion or pregnancy. While others have advocated prethawed, type A plasma for this dilemma [25] , we are concerned of the small risk of hemolysis in critically injured patient. Employing a water bath (Plasmatherm) and 2000 ml thin storage bags, we can thaw a unit of FP24 in < 2.5 minutes.…”

Section: Introductionmentioning

confidence: 99%

Plasma First in the Field for Postinjury Hemorrhagic Shock

Moore¹,

Chin

Chapman

et al. 2014

Shock

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Hemorrhage is the most preventable cause of death in civilian and military trauma and, despite tremendous advances in patient transport in the field, survival within the first hour has changed little over the past 40 years. The pathogenesis of trauma-induced coagulopathy (TIC) is multifactorial, but most authorities believe there is an early depletion of clotting factors. While fresh frozen plasma delivered early in the emergency department has been shown to be beneficial, the rapid onset of TIC suggests advancing this concept to the scene may improve patient outcome. The purpose of this report is to describe the rationale and design of a randomized trial to test the hypothesis that prehospital “plasma-first” resuscitation will benefit the critically injured patient. The rationale includes the possibility that plasma-first resuscitation may be advantageous beyond direct effects on clotting capacity. The study design is based on a ground ambulance system that allows rapid prehospital thawing of frozen plasma.

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“…31 The details of blood product usage are summarized in Table 2. Both the ABO-incompatible and the ABOcompatible plasma groups had an ongoing need for ABOcompatible plasma after their blood groups were identified.…”

Section: Emergent Group a Plasma Transfusions: Outcome Datamentioning

confidence: 99%

How we provide thawed plasma for trauma patients

Stubbs¹,

Zielinski²,

Berns

et al. 2015

Transfusion

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Almost 50% of trauma-related fatalities within the first 24 hours of injury are related to hemorrhage. Improved survival in severely injured patients has been demonstrated when massive transfusion protocols are rapidly invoked as part of a therapeutic approach known as damage control resuscitation (DCR). DCR incorporates the early use of plasma to prevent or correct trauma-induced coagulopathy. DCR often requires the transfusion of plasma before determination of the recipient's ABO group. Historically, group AB plasma has been considered the "universal donor" plasma product. At our facility, the number of AB plasma products produced on an annual basis was found to be inadequate to support the trauma service's DCR program. A joint decision was made by the transfusion medicine and trauma services to provide group A thawed plasma (TP) for in-hospital and prehospital DCR protocols. A description of the implementation of group A TP into the DCR program is provided as well as outcome data pertaining to the use of TP in trauma patients.

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Emergency use of prethawed Group A plasma in trauma patients

Abstract: Therapeutic study, level IV; prognostic study, level III.

Cited by 62 publications

References 27 publications

Implementation and Execution of Civilian Remote Damage Control Resuscitation Programs

Implementation and Execution of Civilian Remote Damage Control Resuscitation Programs

Plasma First in the Field for Postinjury Hemorrhagic Shock

How we provide thawed plasma for trauma patients

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