Prehospital transfusion of red cell concentrates in a paramedic‐staffed helicopter emergency medical service

Abstract

Prehospital transfusion of RCC by paramedics is feasible. Future studies should compare the outcomes of patients receiving prehospital RCCs with outcomes for patients in which RCCs are administered in hospital.

Pre‐hospital transfusion of red blood cells. Part 2: A systematic review of treatment effects on outcomes

“…Blunt injury was most prevalent in the included studies, ranging from 55% to 100% of trauma patients . The mean or median injury severity score (ISS) varied from 18 to 43 (Table ) . The most frequent mechanisms of injury were motor vehicle collisions (42%‐88%) and falls from a height (3.4%‐13%) …”

“…The mean or median injury severity score (ISS) varied from 18 to 43 (Table ) . The most frequent mechanisms of injury were motor vehicle collisions (42%‐88%) and falls from a height (3.4%‐13%) …”

“…Data on non‐trauma patients were reported in 16 civilian studies and made up 3% to 100% of these study cohorts . Suspected gastro‐intestinal bleeding or ruptured aortic aneurysm were the most often reported non‐traumatic diagnoses in transfused patients.…”

“…Six observational studies compared vital parameters or POCT results before and after transfusion . Five of these noted significant beneficial effects of PHTRBC (decrease in heart rate [HR] and shock index [SI], rise in systolic, diastolic or mean arterial blood pressures, less hypotensive episodes (ie, SBP < 90 mmHg) or less “haemodynamic instability”) (Table ).…”

“…Most studies on civilian EMS (11) reported no transfusion reactions occurring . A lung injury associated with a transfusion was reported, and there was one possible adverse reaction in a trauma patient who developed shortness of breath, which was interpreted as secondary to volume overload .…”