Whole Blood Versus Blood Components in Prehospital Care

Area of Science:

• Emergency Medicine
• Trauma Care
• Transfusion Medicine

Background:

• Clinical outcomes of prehospital whole blood versus blood component transfusion for hemorrhaging patients remain unclear.
• Existing studies often include interfacility transfers and focus primarily on trauma patients.

Purpose of the Study:

• To assess and compare clinical outcomes of prehospital whole blood versus blood component transfusion.
• To exclusively evaluate 9-1-1 scene response patients with traumatic and non-traumatic hemorrhage.

Main Methods:

• Retrospective analysis of the ESO Data Collaborative (2019-2023).
• Inclusion of patients aged 8-100 years receiving prehospital transfusion; exclusion of interfacility transports and pre-arrival cardiac arrest.
• Primary outcomes: change in shock index and vital signs; secondary outcome: mortality and adverse events.

Main Results:

• 1,990 eligible patients: 1,515 received whole blood, 475 received blood components.
• Blood components showed greater decreases in shock index and heart rate, but adjusted mortality did not differ significantly between groups.
• No significant adverse events like anaphylaxis or transfusion reactions were reported.

Conclusions:

• Differences in shock index and heart rate changes were clinically insignificant.
• Both whole blood and blood component transfusions appear equally effective and safe for prehospital management of hemorrhage.
• Further research may explore optimal patient selection for each transfusion type.