TY - JOUR
T1 - Pre-hospital transfusion of red blood cells. Part 1
T2 - A scoping review of current practice and transfusion triggers
AU - van Turenhout, Elisabeth C.
AU - Bossers, Sebastiaan M.
AU - Loer, Stephan A.
AU - Giannakopoulos, Georgios F.
AU - Schwarte, Lothar A.
AU - Schober, Patrick
N1 - © 2020 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objectives: The primary aim of this scoping review is to describe the current use of pre-hospital transfusion of red blood cells (PHTRBC) and to evaluate criteria used to initiate PHTRBC. The effects on patients' outcomes will be reviewed in Part 2. Background: Haemorrhage is a preventable cause of death in trauma patients, and transfusion of red blood cells is increasingly used by Emergency Medical Services (EMS) for damage control resuscitation. However, there are no guidelines and little consensus on when to initiate PHTRBC. Methods: PubMed and Web of Science were searched through January 2019; 71 articles were included. Results: Transfusion triggers vary widely and involve vital signs, clinical signs of poor tissue perfusion, point of care measurements and pre-hospital ultrasound imaging. In particular, hypotension (most often defined as systolic blood pressure ≤ 90 mmHg), tachycardia (most often defined as heart rate ≥ 120/min), clinical signs of poor perfusion (eg, prolonged capillary refill time or changes in mental status) and injury type (ie, penetrating wounds) are common pre-hospital transfusion triggers. Conclusions: PHTRBC is increasingly used by Emergency Medical Services, but guidelines on when to initiate transfusion are lacking. We identified the most commonly used transfusion criteria, and these findings may provide the basis for consensus-based pre-hospital transfusion protocols.
AB - Objectives: The primary aim of this scoping review is to describe the current use of pre-hospital transfusion of red blood cells (PHTRBC) and to evaluate criteria used to initiate PHTRBC. The effects on patients' outcomes will be reviewed in Part 2. Background: Haemorrhage is a preventable cause of death in trauma patients, and transfusion of red blood cells is increasingly used by Emergency Medical Services (EMS) for damage control resuscitation. However, there are no guidelines and little consensus on when to initiate PHTRBC. Methods: PubMed and Web of Science were searched through January 2019; 71 articles were included. Results: Transfusion triggers vary widely and involve vital signs, clinical signs of poor tissue perfusion, point of care measurements and pre-hospital ultrasound imaging. In particular, hypotension (most often defined as systolic blood pressure ≤ 90 mmHg), tachycardia (most often defined as heart rate ≥ 120/min), clinical signs of poor perfusion (eg, prolonged capillary refill time or changes in mental status) and injury type (ie, penetrating wounds) are common pre-hospital transfusion triggers. Conclusions: PHTRBC is increasingly used by Emergency Medical Services, but guidelines on when to initiate transfusion are lacking. We identified the most commonly used transfusion criteria, and these findings may provide the basis for consensus-based pre-hospital transfusion protocols.
KW - damage control resuscitation
KW - emergency medical service
KW - major haemorrhage
KW - pre-hospital transfusion
KW - red blood cells
KW - transfusion criteria
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85077898453&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/32080942
UR - http://www.scopus.com/inward/record.url?scp=85077898453&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/tme.12667
DO - https://doi.org/10.1111/tme.12667
M3 - Review article
C2 - 32080942
SN - 0958-7578
VL - 30
SP - 86
EP - 105
JO - Transfusion medicine (Oxford, England)
JF - Transfusion medicine (Oxford, England)
IS - 2
ER -