Blood Product Administration in the Prehospital Setting: A Scoping Review

Area of Science:

• Emergency medicine
• Trauma care
• Critical care

Background:

• Prehospital blood product administration is a global practice for managing hemorrhagic shock in both military and civilian contexts.
• Implementing early transfusions aims to improve patient outcomes in critical bleeding scenarios.

Purpose of the Study:

• To compare international guidelines for prehospital blood product use.
• To evaluate the types of blood products, indications, associated risks, and logistical challenges.
• To determine the safety and efficacy of prehospital blood transfusions.

Main Methods:

• A systematic literature search was conducted across CINAHL, Medline, and Scopus.
• A PRISMA flow diagram guided the screening of 45 articles based on inclusion/exclusion criteria.
• Twenty articles were included in this scoping review.

Main Results:

• Red blood cells were the most common product used (12 studies), often combined with other products.
• Hemodynamic instability was the primary indication for transfusion across various services.
• Most studies reported no adverse reactions; logistical issues were managed through rotation systems in 9 studies.

Conclusions:

• Prehospital blood products are utilized for medical, trauma, and obstetric hemorrhage.
• Diverse blood products and protocols exist, focusing on improving hemodynamic stability.
• The review supports the beneficial and safe application of prehospital blood transfusions.