J Spec Oper Med. 2021 Winter;21(4):11-21. doi: 10.55460/P685-L7R7.
This Clinical Practice Guideline (CPG) provides a brief summary of the scientific literature for prehospital blood use, with an emphasis on the en route care environment. Updates include the importance of calcium administration to counteract the deleterious effects of hypocalcemia, minimal to no use of crystalloid, and stresses the importance of involved and educated en route care medical directors alongside at a competent prehospital and en route care providers (see Table 1). With the paradigm shift to use FDA-approved cold stored low titer group O whole blood (CS-LTOWB) along with the operational need for continued use of walking blood banks (WBB) and point of injury (POI) transfusion, there must be focused, deliberate training incorporating the different whole blood options. Appropriate supervision of autologous blood transfusion training is important for execution of this task in support of deployed combat operations as well as other operations in which traumatic injuries will occur. Command emphasis on the importance of this effort as well as appropriate logistical support are essential elements of a prehospital blood program as part of a prehospital/en route combat casualty care system.
本临床实践指南（CPG）简要总结了院前用血的科学文献，重点介绍了途中护理环境。更新内容包括钙的给药以对抗低钙血症的有害影响、尽量少用晶体液以及强调有经验和受教育的途中护理医疗主任与有能力的院前和途中护理提供者一起发挥重要作用（见表 1）。随着向使用经美国食品药品监督管理局批准的冷藏低滴度 O 型全血（CS-LTOWB）以及继续使用步行血库（WBB）和损伤点（POI）输血的范式转变，必须进行有针对性的、深思熟虑的培训，纳入不同的全血选择。适当监督自体输血培训对于执行支持部署作战行动以及发生创伤性损伤的其他行动的这项任务非常重要。指挥部强调这项工作的重要性以及适当的后勤支持是作为院前/途中战伤救治系统的一部分的院前用血计划的重要组成部分。
