Case Report: Prehospital Whole Blood Transfusion by Texas Helicopter Air Ambulance Crew

Published by JEMS

FULL ARTICLE

By Capt. Alex Merkle, PA-CRandi Schaefer, MSN, RN, ACNS-BC, CENMaj. Remealle How, MD and Terrell Fritz, NRP, FP-C 

The article describes the case of a restrained teenage female driver who was involved in a single-vehicle collision at freeway speed. By report, the vehicle left the roadway at approximately 2:13 p.m. and struck a guardrail. The vehicle remained upright and the impact caused significant vehicle deformity and passenger compartment intrusion.

Due to the severity of the injuries and prolonged extrication, the patient was in a severe state of hemorrhagic shock. Early identification of life-threatening bleeding and aggressive resuscitation, including prehospital blood administration, improved the patient’s chance of survivability to definitive care as evidence by improved vitals and a decreased prehospital shock index of 2.3 to her trauma center arrival with a SI of 1.2.

The artcile concludes that this case adds to the growing body of experience that trauma patients who lose blood benefit from having whole blood as the prehospital resuscitation fluid of choice.

The article also states that compact blood coolers provide reliable storage and transport of products under rugged prehospital conditions. Additionally, the development of compact, battery-operated fluid warmers has allowed for a warmed, rapid administration of products in the prehospital setting. Overcoming the logistical challenges has allowed for expanded use in military and civilian prehospital settings.

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