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医院前全血输血计划的实施和早期结果

Charles Coyle¹, Tony Zitek², Paul E Pepe¹

¹Palm Beach County Fire Rescue, West Palm Beach, FloridaUSA.

Prehospital and disaster medicine

|June 26, 2023

概括

棕县消防救援队为创伤患者实施了全血输血 (WBT) 计划. 尽管存在法律障碍,但该计划显示出希望,有45%的接受者幸存下来,没有报告的不良事件.

科学领域:

紧急医疗紧急医疗
创伤护理的护理人员.
输血药物输血药物输血药物

背景情况:

军事战斗情况已经从基于组件的治疗转向全血输血 (WBT).
创伤中心越来越多地采用了WBT程序,据报道取得了成功.
医院前WBT计划正在出现,更多的紧急医疗服务 (EMS) 系统可能会考虑它们.

研究的目的:

详细介绍佛罗里达州棕县医院前WBT计划的实施情况.
识别和讨论在项目实施过程中遇到的障碍.
介绍接受WBTs的患者的初始结果和病例系列.

主要方法:

棕县消防救援队于2018年启动了医院前WBT计划,通过科学证据教育克服了法律和后勤挑战.
该计划于2022年7月6日开始,使用冷藏,低滴度,白血病减少O+全血.
医院前WBT的指示包括心血压<70mmHg或<90mmHg,心率>110bpm的创伤性损伤.

主要成果:

在计划开始至2022年12月31日期间,881名创伤患者中有20人 (2.3%) 接受了WBT.
接受WBT的9名患者 (45%) 幸存下来.
没有发现与输血相关的不良事件;18个单位在使用前过期.

结论:

棕县消防救援队成功建立了一个医院前的WBT计划,尽管存在重大后勤和法律障碍.
该计划的协议和实施障碍为考虑类似举措的其他EMS系统提供了有价值的见解.
医院前WBT在创伤护理中展示了潜在的拯救生命的好处.

关键词:

紧急医疗服务 (EMS)在医院前的医院.输血输血输血输血一个创伤的创伤创伤.整体血是什么意思?全血是什么意思?

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