A retrospective cohort study from 2017 was the first to conclude that prehospital transfusion is associated with improved survival at 24 hours and at 30 days. In fact, it found a 4-fold sustained survival benefit from rapid transfusion within 30 minutes after injury. The result emphasized that prehospital blood transfusion is an important instrument to achieve zero preventable deaths after injury.

Even though it is intuitive that early transfusion for hemorrhagic shock should improve survival, there was no data that could demonstrate a survival advantage, prior to this publication. Therefore, the author, Stacy A. Shackelford and her co-authers, did some groundbreaking research when they conducted the retrospective cohort study of 502 US military combat casualties undergoing medical evacuation (MEDEVAC) between April 1, 2012, and August 7, 2015.

Of 502 combat casualties, 3 of 55 prehospital transfusion recipients (5%) and 85 of 447 nonrecipients (19%) died within 24 hours of MEDEVAC rescue. By day 30, 6 recipients (11%) and 102 nonrecipients (23%) died. Another important finding was that time to initial transfusion, regardless of location (prehospital or during hospitalization), was associated with reduced 24-hour mortality only up to 15 minutes after MEDEVAC rescue, which again emphasizes how important fast intervention is when treating hemorrhagic shock.

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Source: Shackelford SA, Del Junco DJ, Powell-Dunford N, Mazuchowski EL, Howard JT, Kotwal RS, Gurney J, Butler FK Jr, Gross K, Stockinger ZT. Association of Prehospital Blood Product Transfusion During Medical Evacuation of Combat Casualties in Afghanistan With Acute and 30-Day Survival. JAMA. 2017 Oct 24;318(16):1581-1591. doi: 10.1001/jama.2017.15097. PMID: 29067429; PMCID: PMC5818807

M WARMER

The ˚M Warmer System

The ˚M Warmer is a portable blood and IV fluid warming device optimal for both prehospital and hospital use as it is small, simple to use and has extremely efficient warming capabilities (150 ml/min).