Emergency Medical Service, Päijät-Häme Joint Authority for Health and Wellbeing, Keskussairaalankatu 7, 15850, Lahti, Finland.
Department of Health care and Emergency care, South-Eastern Finland University of Applied Sciences, Pääskysentie 1, 48220, Kotka, Finland.
Scand J Trauma Resusc Emerg Med. 2022 Jun 6;30(1):39. doi: 10.1186/s13049-022-01027-z.
Treating hemorrhaging patients with prehospital blood product transfusions (PHBT) narrows transfusion delays and potentially benefits the patient. We describe our initial experiences of PHBT in a ground-based emergency medical service (EMS), where the transfusion protocol covers both traumatic and nontraumatic hemorrhaging patients.
A descriptive retrospective analysis was performed on the records of all the patients receiving red blood cells, freeze-dried plasma, or both during prehospital care from September 2016 to December 2020. The delays of PHBT and the effects on patients' vital signs were analyzed and reported as the median and interquartile range (IQR) and analyzed using a Wilcoxon Signed rank test.
65 patients received prehospital blood product transfusions (PHBT), 29 (45%) were non-traumatic, and 36 (55%) traumatic. The main two reasons for PHBT were blunt trauma (n = 30, 46%) and gastrointestinal hemorrhage (n = 20, 31%). The median time from the emergency call to the start of PHBT was 54 min (IQR 38), and the transfusion began on a median of 61 min (IQR 42) before arrival at the hospital. The median systolic blood pressure improved from a median 76.5 mmHg (IQR 36.5) before transfusion to a median of 116.60 mmHg (IQR 26.5) (p < 0.001) on arrival to the hospital. No transfusion-related severe adverse events were noted.
Starting PHBT in ground-based EMS is a feasible and viable option. The PHBT began significantly earlier than it would have started on arrival to the hospital, and it seems to be safe and improve patients' physiology.
D/2603/07.01.04.05/2019.
在院前进行血液制品输注（PHBT）治疗出血患者可以缩短输血延迟时间，并可能对患者有益。我们描述了在基于地面的紧急医疗服务（EMS）中进行 PHBT 的初步经验，该服务的输血方案涵盖了创伤性和非创伤性出血患者。
对 2016 年 9 月至 2020 年 12 月期间在院前接受红细胞、冻干血浆或两者输注的所有患者的记录进行了描述性回顾性分析。分析并报告了 PHBT 的延迟时间以及对患者生命体征的影响，中位数和四分位距（IQR）表示，并使用 Wilcoxon 符号秩检验进行分析。
65 例患者接受了院前血液制品输注（PHBT），29 例（45%）为非创伤性，36 例（55%）为创伤性。PHBT 的主要两个原因是钝性创伤（n=30，46%）和胃肠道出血（n=20，31%）。从紧急呼叫到开始 PHBT 的中位时间为 54 分钟（IQR 38），在到达医院前中位时间为 61 分钟（IQR 42）开始输血。在到达医院时，收缩压中位数从输血前的 76.5mmHg（IQR 36.5）改善至 116.60mmHg（IQR 26.5）（p<0.001）。未观察到与输血相关的严重不良事件。
在基于地面的 EMS 中开始 PHBT 是一种可行且可行的选择。PHBT 开始时间明显早于到达医院时的开始时间，并且似乎是安全的，可改善患者的生理状况。
D/2603/07.01.04.05/2019。
