Graduate Program in Nurse Anesthesia, Texas Wesleyan University, Fort Worth, TX; Department of Anesthesia, John Peter Smith Hospital, Fort Worth, TX; Department of Anesthesia, Ochsner LSU Health, Shreveport, LA.
Department of Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, LA.
Air Med J. 2023 Sep-Oct;42(5):353-357. doi: 10.1016/j.amj.2023.05.007. Epub 2023 Jun 26.
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.
空中医疗服务可以改善受伤时的血液制品获取。研究表明，早期启动大量输血方案 (MTP) 可以将创伤患者的生存率提高多达 25%。有几种评分系统可以指导早期激活，但单一标准的使用一直难以实现。我们的研究旨在确定空中医疗用血是否是大量输血激活的危险因素，以及是否利用院前生命体征计算休克指数。在我们的回顾性研究中，我们评估了接受直升机紧急医疗服务 (HEMS) 输血的成年创伤患者，并将我们机构中接受 MTP 的所有患者作为对照。我们的研究发现，HEMS 输血并不是 MTP 的可靠触发因素，尽管样本量可能限制了我们的发现。我们发现，HEMS 护理导致创伤中心到达时的输血总量减少和血流动力学参数改善。HEMS 输血和更高的氨甲环酸使用率可能促成了这些发现。值得注意的是，研究人群中血液消耗评分和休克指数的评估不具有特异性。
