Episode 217: Prehospital Blood Transfusion скачать в хорошем качестве

Episode 217: Prehospital Blood Transfusion

Episode 217: Prehospital Blood Transfusion Link: https://coreem.net/podcast/episode-21... We discuss the shift to prehospital blood transfusion to treat shock earlier. Hosts • Nichole Bosson, MD, MPH, FACEP • Avir Mitra, MD Audio • Listen/Download: https://media.blubrry.com/coreem/cont... Tags EMS, Prehospital Care, Trauma ⸻ Show Notes Core EM Modular CME Course Maximize your commute with the Core EM Modular CME Course, featuring essential content distilled from top-rated podcast episodes. This course includes 12 audio-based modules packed with pearls. Course highlights • Credit: 12.5 AMA PRA Category 1 Credits™ • Curriculum: Core Emergency Medicine (12 modules spanning topics from Critical Care to Pediatrics) • Cost: • Free for NYU Learners • $250 for Non-NYU Learners Register: https://www.highmarksce.com/nyumc/Pla... ⸻ What is prehospital blood transfusion? • Administration of blood products in the field prior to hospital arrival • Aimed at patients in hemorrhagic shock Why this matters • Traditional US prehospital resuscitation relied heavily on crystalloid • ED and trauma care now prioritize early blood products • Hemorrhage occurs before hospital arrival • Delays to definitive hemorrhage control are common • Earlier blood may improve survival Supporting rationale • ATLS and modern trauma paradigms emphasize blood over crystalloid for hemorrhagic shock • National organizations support prehospital blood when feasible • EMS already performs high-risk, time-sensitive interventions Evidence overview • Data are mixed and evolving: • COMBAT: no benefit • PAMPer: mortality benefit • RePHILL: no clear benefit • Signal toward benefit when transport time exceeds about 20 minutes • Even urban systems may experience long delays due to traffic and geography • LA County median time to in-hospital transfusion is about 35 minutes LA County program • About 2 years of planning before launch • Pilot began April 1 • Partnerships included: • LA County Fire • Compton Fire • Local trauma centers • San Diego Blood Bank • 14 units of blood circulating in the field • Blood rotated back 14 days before expiration • Ultimately used at Harbor-UCLA • Continuous temperature and safety monitoring Indications used in LA County • Focused rollout • Trauma-related hemorrhagic shock • Postpartum hemorrhage ...