While airway compromise and hemorrhage are being leading causes of preventable battlefield death, both civilian and military trauma experts have focused on the prehospital phase of care for reducing preventable trauma deaths in the joint “Zero Preventable Deaths” initiative. Rapid sequence intubation is the most common method of securing a definitive airway, and early blood product administration is associated with improved mortality. Military combat trauma guidelines, for this reason, recommend early blood product resuscitation.
However, the relationship between these two tenets of trauma is not fully understood. Rapid sequence intubation of the trauma victim after hemorrhage represents a precarious phase of care often marked by significant hemodynamic instability and potential pulseless arrest in the setting of hypovolemic shock. So, the goal of this study was to compare mortality, postintubation hypotension (PIH), and pulseless arrest (PA) among trauma patients receiving blood products before intubation versus those who received no blood products.
Out of a total of 153 patients, 81 (53%) patients received preintubation blood products and had similar characteristics to those who did not receive transfusions. The authors compared rates of postintubation systolic blood pressure, pulseless arrest, and mortality at 24 hours and 30 days among patients who did and did not receive blood products before intubation.
Within the context of this historical cohort, the early use of blood products conferred a statistically significant benefit in reducing postintubation hypotension and pulseless arrest among combat trauma victims exposed to traumatic hemorrhage. These findings may have implications toward the shared military and civilian trauma communities’ goal of further reducing preventable death after injury.
Read the full text here. https://academic.oup.com/milmed/article/186/Supplement_1/316/6119469
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