A study published in Crit_Care finds that prehospital plasma transfusion in addition to red blood cell (RBC) transfusion is associated with lower odds of death at 24 hours compared to RBC transfusion alone.
]. In the United Kingdom , most prehospital services carry RBC and thawed plasma. Due to storage requirements, it is not possible to carry platelets in the prehospital setting. Currently, in the UK, the leukocyte depletion process introduced in the 1990s to reduce the risk of variant CJD transmission via blood transfusion removes 80% of platelets in whole blood donations, and therefore, the remaining component contains red cells and plasma in one bag [].
The overall objective of this multicenter observational cohort study was to evaluate the effect of prehospital RCP transfusion on 24-h mortality and 30-day mortality in traumatically injured bleeding patients, when compared with prehospital RBC transfusion only and prehospital RBC plus plasma transfusion .The study received ethical approval from the UK Health Research Authority . Data were collected from six Helicopter Emergency Medical Services in England.
All services recommended that patients were transfused blood if there was: a) clinical suspicion of hemorrhage and b) systolic blood pressure was < 90 mmHg . In cases without documented non-invasive blood pressure, patients with central pulse only were assumed to have a systolic blood pressure of 40 mmHg, a femoral pulse of 60 mmHg, and a radial pulse of 80 mmHg. Patients in cardiac arrest were described as having no central pulse or heart rate.
Clinical data included information on demographics, incident characteristics prior to hospital arrival abbreviated injury score and injury severity scores , resuscitative parameters and laboratory test results within the first 24 h of emergency department arrival, in-hospital transfusion requirement at 24 h, morbidity , and 24-h and 30-day mortality. Cause of death was collected in a standardized way from all hospitals using death certificate, coroner’s report, or clinical notes .
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