McNeilly Bryan, Samsey Kathleen, Kelly Seth, Pennardt Andre, Guyette Francis X
Department of Emergency Medicine, University of Washington, Seattle, Washington, USA.
US Army Medical Center of Excellence, Fort Sam Houston, Texas, USA.
J Am Coll Emerg Physicians Open. 2025 Jan 24;6(2):100041. doi: 10.1016/j.acepjo.2024.100041. eCollection 2025 Apr.
Following the military's advancement of prehospital blood into the field, civilian prehospital blood programs are becoming more prevalent. However, there are significant differences between civilian and military prehospital operations that should be considered. Civilian prehospital systems also vary widely in terms of resources, transport times, and patient types. Given these variations and the logistical challenges associated with establishing a prehospital blood program, careful consideration of the state of the science is warranted. Although blood is the preferred fluid for patients in hemorrhagic shock, there have only been a few high-quality studies that have examined the efficacy of administering blood in the prehospital setting. Given the conflicting results of these studies, individual medical directors must determine whether the risk-benefit analysis for their system warrants establishing such a resource-intensive operation. Efforts to establish a prehospital blood program should not supersede attempts to optimize the fundamental components of trauma operations and management.
随着军队将院前输血引入战场，民用院前输血项目正变得越来越普遍。然而，民用和军事院前行动之间存在显著差异，应予以考虑。民用院前系统在资源、转运时间和患者类型方面也存在很大差异。鉴于这些差异以及建立院前输血项目所带来的后勤挑战，有必要仔细考虑科学现状。尽管血液是失血性休克患者的首选液体，但仅有少数高质量研究考察了院前输血的疗效。鉴于这些研究结果相互矛盾，各医疗主管必须确定其系统的风险效益分析是否足以支持开展这样一项资源密集型行动。建立院前输血项目的努力不应取代优化创伤手术和管理基本要素的尝试。
