Prehospital blunt traumatic arrest resuscitation augmented by whole blood: a case report

Transfusion
Julian G MappChristopher Winckler

Abstract

Prehospital hemorrhagic shock accounts for approximately 25,000 civilian deaths annually in the United States. A balanced, blood-based resuscitation strategy is hypothesized to be the optimal treatment for these patients. Due to logistical constraints, delivering a balanced, blood-based resuscitation is difficult in the prehospital setting. A low titer O+ whole blood (LTO+ WB) ground ambulance initiative, may help alleviate this capability gap. A 37-year-old female was involved in a motor vehicle collision at approximately 16:30. While she was trapped inside the vehicle, her mental status deteriorated. The patient was successfully extricated at 17:04 and found to be in cardiac arrest. The paramedics and firefighters quickly secured her airway and applied a mechanical CPR device. The first responder team obtained return of spontaneous circulation, but the patient's blood pressure was 43/27 mmHg. The paramedics transfused one unit of LTO+ WB. Twenty-one minutes after the initial LTO+ WB transfusion, the air ambulance team transfused a second unit of LTO+ WB. Upon hospital arrival, the transfusion was completed, and the patient's shock index improved to 1.0. The trauma team identified a grade 5 splenic injury with active extravasa...Continue Reading

References

Jul 10, 2012·Critical Care : the Official Journal of the Critical Care Forum·Jörn ZwingmannPeter C Strohm
Sep 17, 2013·Journal of Clinical Epidemiology·Joel J GagnierUNKNOWN CARE Group
Apr 14, 2016·The Journal of Trauma and Acute Care Surgery·Christopher C D EvansUNKNOWN Resuscitation Outcomes Consortium Investigators
Aug 24, 2017·Current Opinion in Hematology·Philip C Spinella, Andrew P Cap
Nov 15, 2017·Emergency Medicine Clinics of North America·Chris EvansJonathan Sherbino
Sep 25, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Ryan NewberryJulian Mapp

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Citations

Oct 14, 2021·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·William BullockChristopher Cj Winckler

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