Cargando…
Pre-hospital blood transfusion – an ESA survey of European practice
BACKGROUND: Blood products are a lifesaving commodity in the treatment of major trauma. Although there is little evidence for use of pre-hospital blood products (PHBP) in seriously injured patients, an increasing number of emergency medical services have started using PHBP for treatment of major hae...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427720/ https://www.ncbi.nlm.nih.gov/pubmed/32795320 http://dx.doi.org/10.1186/s13049-020-00774-1 |
_version_ | 1783570934731374592 |
---|---|
author | Thies, Karl-Christian Truhlář, Anatolij Keene, Damian Hinkelbein, Jochen Rützler, Kurt Brazzi, Luca Vivien, Benoît |
author_facet | Thies, Karl-Christian Truhlář, Anatolij Keene, Damian Hinkelbein, Jochen Rützler, Kurt Brazzi, Luca Vivien, Benoît |
author_sort | Thies, Karl-Christian |
collection | PubMed |
description | BACKGROUND: Blood products are a lifesaving commodity in the treatment of major trauma. Although there is little evidence for use of pre-hospital blood products (PHBP) in seriously injured patients, an increasing number of emergency medical services have started using PHBP for treatment of major haemorrhage. The primary aim of this survey was to establish the degree of prehospital blood product use throughout Europe and discover main indications. The secondary aim was to evaluate opinions about PHBP and also the experience and the personal views of its users. METHODS: The subcommittee for Critical Emergency Medicine of the European Society of Anaesthesiology (ESA) held an online survey of European Helicopter Emergency Services (HEMS) and all French Services d’Aide Médicale Urgente (SAMU) regions. It contained 13 questions both open and multiple-choice about the frequency transfusions are carried out, the PHBP used and the perceived benefit. The survey was distributed to the corresponding HEMS leads in 14 European countries. RESULTS: In total there were 172 valid responses; overall 48% of all respondents have prehospital access to packed red cells, 22% to fresh plasma and 14% use lyophilised plasma. Besides blood product administration, 94% of all services use tranexamic acid. Sixty five percent of all replies came from French and from German services (37 and 28% respectively). PHBP were mainly used for trauma related emergencies. France has the highest uptake of use of blood products at 89%, whereas the rate in Germany was far lower at 6%. Fifty five percent of the service leads felt that PHBP are beneficial, and even lifesaving in individual cases despite being needed infrequently. CONCLUSIONS: We found remarkable dissimilarities in practice between the different European countries. Even if there is not an absolute consensus amongst providers on the benefit of PHBP, the majority feel they are beneficial. The difference in practice is possibly related to the perceived lack of evidence on prehospital blood transfusion. We suggest to include the use of PHBP in trauma registries in order to consolidate the existing evidence. |
format | Online Article Text |
id | pubmed-7427720 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74277202020-08-17 Pre-hospital blood transfusion – an ESA survey of European practice Thies, Karl-Christian Truhlář, Anatolij Keene, Damian Hinkelbein, Jochen Rützler, Kurt Brazzi, Luca Vivien, Benoît Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Blood products are a lifesaving commodity in the treatment of major trauma. Although there is little evidence for use of pre-hospital blood products (PHBP) in seriously injured patients, an increasing number of emergency medical services have started using PHBP for treatment of major haemorrhage. The primary aim of this survey was to establish the degree of prehospital blood product use throughout Europe and discover main indications. The secondary aim was to evaluate opinions about PHBP and also the experience and the personal views of its users. METHODS: The subcommittee for Critical Emergency Medicine of the European Society of Anaesthesiology (ESA) held an online survey of European Helicopter Emergency Services (HEMS) and all French Services d’Aide Médicale Urgente (SAMU) regions. It contained 13 questions both open and multiple-choice about the frequency transfusions are carried out, the PHBP used and the perceived benefit. The survey was distributed to the corresponding HEMS leads in 14 European countries. RESULTS: In total there were 172 valid responses; overall 48% of all respondents have prehospital access to packed red cells, 22% to fresh plasma and 14% use lyophilised plasma. Besides blood product administration, 94% of all services use tranexamic acid. Sixty five percent of all replies came from French and from German services (37 and 28% respectively). PHBP were mainly used for trauma related emergencies. France has the highest uptake of use of blood products at 89%, whereas the rate in Germany was far lower at 6%. Fifty five percent of the service leads felt that PHBP are beneficial, and even lifesaving in individual cases despite being needed infrequently. CONCLUSIONS: We found remarkable dissimilarities in practice between the different European countries. Even if there is not an absolute consensus amongst providers on the benefit of PHBP, the majority feel they are beneficial. The difference in practice is possibly related to the perceived lack of evidence on prehospital blood transfusion. We suggest to include the use of PHBP in trauma registries in order to consolidate the existing evidence. BioMed Central 2020-08-14 /pmc/articles/PMC7427720/ /pubmed/32795320 http://dx.doi.org/10.1186/s13049-020-00774-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Research Thies, Karl-Christian Truhlář, Anatolij Keene, Damian Hinkelbein, Jochen Rützler, Kurt Brazzi, Luca Vivien, Benoît Pre-hospital blood transfusion – an ESA survey of European practice |
title | Pre-hospital blood transfusion – an ESA survey of European practice |
title_full | Pre-hospital blood transfusion – an ESA survey of European practice |
title_fullStr | Pre-hospital blood transfusion – an ESA survey of European practice |
title_full_unstemmed | Pre-hospital blood transfusion – an ESA survey of European practice |
title_short | Pre-hospital blood transfusion – an ESA survey of European practice |
title_sort | pre-hospital blood transfusion – an esa survey of european practice |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427720/ https://www.ncbi.nlm.nih.gov/pubmed/32795320 http://dx.doi.org/10.1186/s13049-020-00774-1 |
work_keys_str_mv | AT thieskarlchristian prehospitalbloodtransfusionanesasurveyofeuropeanpractice AT truhlaranatolij prehospitalbloodtransfusionanesasurveyofeuropeanpractice AT keenedamian prehospitalbloodtransfusionanesasurveyofeuropeanpractice AT hinkelbeinjochen prehospitalbloodtransfusionanesasurveyofeuropeanpractice AT rutzlerkurt prehospitalbloodtransfusionanesasurveyofeuropeanpractice AT brazziluca prehospitalbloodtransfusionanesasurveyofeuropeanpractice AT vivienbenoit prehospitalbloodtransfusionanesasurveyofeuropeanpractice |