Proceedings (Baylor University. Medical Center) · 2026
Potential utility of prehospital blood for trauma patients in a dense, urban setting: simulations of prehospital travel times.
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Roden-Foreman Jacob W, Cheung Michael, Edmundson Philip, Tibbs Brian
Аннотация
BACKGROUND: There is increasing interest in allowing emergency medical services (EMS) to transfuse blood for patients with traumatic hemorrhage. National estimates suggest that prehospital blood could save thousands of lives annually, but the usefulness of prehospital blood in dense, urban settings is unclear.
METHODS: This retrospective cohort study examined all 294 patients arriving via EMS to our urban trauma center in 2016 to 2019 who received blood within 4 hours. The feasibility of prehospital blood transfusion was investigated by simulating EMS travel times. Generalized additive modeling examined associations between EMS travel time and mortality.
RESULTS: The median [Q1, Q3] EMS travel time was 9 [6, 13] minutes. Simulations indicated that 11% (95% CI = 9%-14%) of travel times are long enough to transfuse a full unit of blood (>15 minutes). Travel time was positively associated with mortality after penetrating injury (odds ratio = 1.15) but not blunt injury (odds ratio = 1.01).
CONCLUSIONS: This study suggests a potential mortality benefit from earlier blood product resuscitation following penetrating injury. However, simulations suggest that <15% of eligible patients could benefit from prehospital blood due to short EMS travel times. Urban trauma systems should likely not expect mortality reductions from prehospital blood that are proportionate to national estimates.
METHODS: This retrospective cohort study examined all 294 patients arriving via EMS to our urban trauma center in 2016 to 2019 who received blood within 4 hours. The feasibility of prehospital blood transfusion was investigated by simulating EMS travel times. Generalized additive modeling examined associations between EMS travel time and mortality.
RESULTS: The median [Q1, Q3] EMS travel time was 9 [6, 13] minutes. Simulations indicated that 11% (95% CI = 9%-14%) of travel times are long enough to transfuse a full unit of blood (>15 minutes). Travel time was positively associated with mortality after penetrating injury (odds ratio = 1.15) but not blunt injury (odds ratio = 1.01).
CONCLUSIONS: This study suggests a potential mortality benefit from earlier blood product resuscitation following penetrating injury. However, simulations suggest that <15% of eligible patients could benefit from prehospital blood due to short EMS travel times. Urban trauma systems should likely not expect mortality reductions from prehospital blood that are proportionate to national estimates.