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. 2021 Oct 22;48(6):324-331.
doi: 10.1159/000519676. eCollection 2021 Dec.

Prehospital Whole Blood Transfusion Programs in Norway

Christopher Kalhagen Bjerkvig  1   2   3   4 , Geir Strandenes  5   6 , Tor Hervig  5   7 , Geir Arne Sunde  1   4 , Torunn Oveland Apelseth  3   5   6
Affiliations

Prehospital Whole Blood Transfusion Programs in Norway

Christopher Kalhagen Bjerkvig et al. Transfus Med Hemother. .

Abstract

Background: Prehospital management of severe hemorrhage has evolved significantly in Norwegian medical emergency services in the last 10 years. Treatment algorithms for severe bleeding were previously focused on restoration of the blood volume by administration of crystalloids and colloids, but now the national trauma system guidelines recommend early balanced transfusion therapy according to remote damage control resuscitation principles.

Materials and methods: This survey describes the implementation, utilization, and experience of the use of low titer group O whole blood (LTOWB) and blood components in air ambulance services in Norway. Medical directors from all air ambulance bases in Norway as well as the blood banks that support LTOWB were invited to participate.

Results: Medical directors from all 13 helicopter emergency medical services (HEMS) bases, the 7 search and rescue (SAR) helicopter bases, and the 4 blood banks that support HEMS with LTOWB responded to the survey. All HEMS and SAR helicopter services carry LTOWB or blood components. Four of 20 (20%) HEMS bases have implemented LTOWB. A majority of services (18/20, 90%) have a preference for LTOWB, primarily because LTOWB enables early balanced transfusion and has logistical benefits in time-critical emergencies and during prolonged evacuations.

Conclusion: HEMS services and blood banks report favorable experiences in the implementation and utilization of LTOWB. Prehospital balanced blood transfusion using whole blood is feasible in Norway.

Keywords: Air ambulance; Bleeding; Prehospital blood transfusion; Trauma; Whole blood.

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Conflict of interest statement

The authors declare that they have no conflicts of interest relevant to the manuscript submitted to Transfusion Medicine and Hemotherapy. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Norwegian Armed Forces Medical Services.

Figures

Fig. 1
Fig. 1
The location and inventory of the HEMS and SAR helicopter bases in Norway.
Fig. 2
Fig. 2
The number of transfusion events at the individual HEMS and SAR helicopter base in 2020.
Fig. 3
Fig. 3
The rationale for implementation of LTOWB at the four HEMS bases.
See this image and copyright information in PMC

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