用于大规模伤亡事件的全血调配计划：南得克萨斯州在区域响应和准备方面的经验。
Use of whole blood deployment programs for mass casualty incidents: South Texas experience in regional response and preparedness.
机构信息
From the Department of Surgery (A.C., E.B., M.B., B.E., R.S., L.L., S.N., D.J.), University of Texas Health Science Center at San Antonio; Acadian Ambulance Service (E.K.); and STRAC Regional Whole Blood Program (C.J.W., E.E., J.F., J.B., D.D., E.W.), San Antonio, Texas.
出版信息
J Trauma Acute Care Surg. 2022 Dec 1;93(6):e182-e184. doi: 10.1097/TA.0000000000003762. Epub 2022 Aug 31.
INTRODUCTION
Firearm-related deaths have become the leading cause of death in adolescents and children. Since the Sutherland Springs, TX mass casualty incident (MCI), the Southwest Texas Regional Advisory Council for trauma instituted a prehospital whole blood (WB) program and blood deployment program for MCIs.
METHODS
The program was adopted statewide by the Texas Emergency Medical Task Force, of which Southwest Texas Regional Advisory Council is the lead for Emergency Medical Task Force 8. The recent active shooter MCI in Uvalde, TX was the first time the MCI blood deployment program had been used. To our knowledge, no other similar programs exist in this or any other country.
RESULTS
On May 24, 2022, 19 children and 2 adults were killed at an MCI in Uvalde, TX. The MCI WB deployment protocol was initiated, and South Texas Blood and Tissue Center prepared 15 U of low-titer O-positive whole blood and 10 U of leukoreduced O packed cells. The deployed blood arrived at Uvalde Memorial Hospital within 67 minutes. One of the pediatric patients sustained multiple gunshots to the chest and extremities. The child was hypotensive and received 2 U of leukoreduced O packed cells, one at the initial hospital and another during transport. On arrival, the patient required 2 U of low-titer O-positive whole blood and underwent a successful hemorrhage control operation. The remaining blood was returned to South Texas Blood and Tissue Center for distribution.
CONCLUSION
Multiple studies have shown the association of early blood product resuscitation and improved mortality, with WB being the ideal resuscitative product for many. The ongoing efforts in South Texas serve as a model for development of similar programs throughout the country to reduce preventable deaths. This event represents the first ever successful deployment of WB to the site of an MCI related to a school shooting in the modern era.
LEVEL OF EVIDENCE
Therapeutic/Care Management; Level V.
引言
枪支相关死亡已成为青少年和儿童的主要致死原因。自德克萨斯州萨瑟兰斯普林斯大规模伤亡事件（MCI）以来，西南德克萨斯地区创伤咨询委员会为 MCI 建立了一个院前全血（WB）计划和血液调配计划。
方法
该计划已被德克萨斯州紧急医疗工作队全州采用，其中西南德克萨斯地区创伤咨询委员会是第 8 号紧急医疗工作队的领导。最近在德克萨斯州尤瓦尔迪发生的一起活跃枪手 MCI 是首次使用 MCI 血液调配计划。据我们所知，在这个或任何其他国家都没有其他类似的计划。
结果
2022 年 5 月 24 日，德克萨斯州尤瓦尔迪的一起 MCI 事件造成 19 名儿童和 2 名成年人死亡。MCI 全血调配协议启动后，南德克萨斯血液和组织中心准备了 15 单位低滴度 O 阳性全血和 10 单位白细胞减少的 O 型浓缩红细胞。调配的血液在 67 分钟内送达尤瓦尔迪纪念医院。一名儿科患者胸部和四肢多处中枪。该患儿血压低，接受了 2 单位白细胞减少的 O 型浓缩红细胞，一次在初始医院，另一次在转运途中。到达后，患者需要 2 单位低滴度 O 阳性全血，并成功进行了出血控制手术。其余血液被送回南德克萨斯血液和组织中心分发。
结论
多项研究表明，早期血液制品复苏与死亡率降低相关，而 WB 是许多情况下理想的复苏产品。德克萨斯州南部的持续努力为全国范围内类似计划的发展提供了模式，以减少可预防的死亡。这一事件代表了现代史上首次成功将 WB 调配到与学校枪击事件相关的 MCI 现场。
证据水平
治疗/护理管理；等级 V。
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