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. 2023 Sep-Oct;42(5):353-357.
doi: 10.1016/j.amj.2023.05.007. Epub 2023 Jun 26.

Air Medical Blood Transfusion as a Trigger of Massive Transfusion Protocol

Brian Cornelius  1 , Dennis Thompson  2 , Phillip Kilgore  3 , Urska Cvek  3 , Marjan Trutschl  3 , Navdeep Samra  4 , Angela Cornelius  5
Affiliations

Air Medical Blood Transfusion as a Trigger of Massive Transfusion Protocol

Brian Cornelius et al. Air Med J. 2023 Sep-Oct.

Abstract

Air medical services can improve access to blood products at the point of injury. Studies have shown that early activation of mass transfusion protocols (MTPs) can improve the survival of trauma patients by up to 25%. There are several scoring systems to guide early activation, but the use of a single criterion has been elusive. Our study sought to determine if air medical administration of blood products was a risk factor for massive transfusion activation and utilization of prehospital vital signs for calculation of the shock index. In our retrospective study, we evaluated adult trauma patients transfused by helicopter emergency medical services (HEMS) and as a control all patients in our institution receiving the MTP. Our study found HEMS blood transfusion was not a reliable trigger for MTP, although the sample size may have limited our findings. We found that HEMS care resulted in an overall reduction in the volume of transfusion and an improvement in hemodynamic parameters upon trauma center arrival. HEMS transfusion and a higher rate of tranexamic acid administration may have contributed to these findings. Of note, the assessment of blood consumption score and shock index were nonspecific in the study populations.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Chart 1.
Chart 1.. HEMS Vs ED Shock Index
(HEMS-Helicopter EMS, ED-Emergency Department, SI-Shock Index)
Chart 2
Chart 2. Transfusion Data
(HEMS-Helicopter Emergency Medical Services, MTP-Massive Transfusion Protocol, FFP-Fresh Frozen Plasma, RBC-Red Blood Cell, PLT-Platelet, CRYO-Cryoprecipitate)
Chart 3
Chart 3
ROC Data for HEMS and Emergency Department
Chart Four
Chart Four. Demographic Data, Lab Values and Outcomes
(ISS-Injury Severity Score, HGB-Hemoglobin, HCT-Hematocrit, HEMS-Helicopter Emergency Medical Services, MTP-Massive Transfusion Protocol)
Chart Five
Chart Five. Tranexamic Acid Use
(TXA-Tranexamic Acid, HEMS-Helicopter Emergency Medical Services, MTP-Massive Transfusion Protocol, ED-Emergency Department)
Chart Six
Chart Six. Hemodynamic Changes
(HEMS-Helicopter Emergency Medical Services, MTP-Massive Transfusion Protocol, SBP-Systolic Blood Pressure, HR-Heart Rate)
See this image and copyright information in PMC

References

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