Prehospital Whole Blood in Trauma-A Scoping Review

Area of Science:

• Emergency Medicine
• Trauma Care
• Resuscitation Science

Background:

• The management of hemorrhagic shock in trauma patients is evolving.
• Prehospital whole blood (WB) administration is re-emerging for coagulopathy correction and improved survival.
• This review focuses on the application of prehospital WB in adult trauma patients.

Purpose of the Study:

• To evaluate the current use and outcomes of prehospital whole blood (WB) in adult trauma patients experiencing hemorrhagic shock.
• To synthesize findings from recent literature on prehospital WB administration.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Embase, and CINAHL.
• Studies published between January 2015 and March 2024 were included.
• A scoping review methodology was employed.

Main Results:

• Ten studies, encompassing 9,621 patients, were analyzed.
• The reviewed studies included case series, a randomized controlled trial, and observational studies.
• Eight studies focused on civilian populations, while two involved military settings.

Conclusions:

• Prehospital WB programs appear feasible and safe for trauma and other patient groups.
• The quality and design of existing studies are suboptimal, limiting definitive conclusions.
• Further high-quality research is required to establish robust recommendations for prehospital WB use.