Tips, tricks, and thoughts on the future of prehospital blood transfusions

Yazer, Mark H.; Beckett, Andrew; Corley, Jason B; Devine, Dana V.; Studer, Nicholas M; Taylor, Audra L; Ward, Kevin R.; Andrew, P.

doi:10.1111/trf.16955

Cited by 2 publications

(3 citation statements)

References 36 publications

(57 reference statements)

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“…Multi-product transfusion has demonstrated improvement in patient outcomes, but there is limited research regarding the success of using prehospital blood products by ground units for patients with time-sensitive injuries and a lengthy prehospital course of care. 2 Receiving transfusion in the prehospital setting has shown lower mortality in the emergency department, the PAMPer study demonstrated 30-day mortality benefits and safety in helicopter transport, and the shift continues away from crystalloid solutions as initial resuscitation agents. 2 Switching the focus on point of injury resuscitation for our ground crews, with blood products, in our rural landscape is paramount.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…2 Receiving transfusion in the prehospital setting has shown lower mortality in the emergency department, the PAMPer study demonstrated 30-day mortality benefits and safety in helicopter transport, and the shift continues away from crystalloid solutions as initial resuscitation agents. 2 Switching the focus on point of injury resuscitation for our ground crews, with blood products, in our rural landscape is paramount. The Georgia Office of EMS and Trauma states "EMS personnel are permitted to perform only those skills listed under their licensure level, and only once they have been trained on those skills, certified as competent, credentialed to perform those skills by their local EMS Medical Director, and only while operating under standing, verbal, or written orders from their local EMS Medical Director, transferring physician or a Medical Control physician."…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Changing the Playing Field: A Prehospital Blood Product Pilot Project in Rural North Georgia

Creel

Gibson

et al. 2023

The American Surgeon™

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Background In Georgia, the paramedic’s scope of practice prohibited the initiation of blood products. Due to the rural landscape in Georgia, one region’s Regional Trauma Advisory Committee (RTAC) advocated expanding the scope of practice for Georgia’s paramedics to allow them to initiate blood products in the prehospital environment. This study evaluated the safety and feasibility of allowing paramedics to initiate blood products for hemorrhaging patients utilizing a regionally established prehospital blood pilot program. Materials and Methods Approval was obtained from the state medical directors and the Office of EMS and Trauma. The project team addressed product selection, equipment, prehospital service selection, education, policies and procedures, monitoring, and performance improvement. Four EMS services were identified to participate. Liquid plasma was selected due to cost and availability. Equipment was secured for blood storage and temperature monitoring to ensure the hospital’s blood bank could maintain standards for exchange. A transfusion guideline was created, an administrative policy was developed, and an education plan was developed. A process with the trauma center’s blood bank was also instituted to minimize waste and reduce costs. Results and Discussion The pilot project began in spring of 2020, and as of January 2023, there have been 100 field initiations and no adverse effects, demonstrating the safety of paramedics to initiate blood products in the field. A post-licensure skill for paramedics is now available in Georgia for the initiation of blood products. The repeatability of a similar project depends on the resources available, the stakeholder commitment, and the partnerships across disciplines.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%