Prehospital Whole Blood in Trauma-A Scoping Review

Abstract

Objective: The management of blood resuscitation in hemorrhagic shock in trauma patients is evolving. Prehospital whole blood (WB) re-emerged into practice to correct coagulopathy, replace blood loss, and improve survival. This scoping review evaluated the use of prehospital WB in adult trauma patients with hemorrhagic shock.

Methods: We performed a literature search using PubMed, Embase, and CINAHL, including studies published between January 2015 and March 2024.

Results: A total of 10 studies (n = 9,621) were reviewed. Studies included 2 case series, 1 prospective randomized controlled trial, and 7 observational studies. Eight studies evaluated civilian patient populations (1 non-trauma, 7 trauma) and 2 were military (1 trauma, 1 mixed trauma/non-trauma).

Conclusion: Prehospital WB programs are feasible and relatively safe. They may be beneficial in trauma and other populations; however, the reviewed studies are poor in quality and suboptimal in study design. Thus, definitive recommendations cannot be made. Additional studies are required.