We have seen a great development in the understanding of time as a key parameter in the treatment of trauma patients. Learnings from the military has been translated and implemented to the civil world, and there is a continuous focus on further understanding how time, from the injury occurs to treatment starts, can be shortened.

The Golden Hour standard has been known for decades. The purpose of the standard was to ensure treatment of an injured soldier within sixty minutes of injury. Though, the policy has been credited with saving as many as 359 lives between 2009 and 2013, we know today that time from injury to treatment needs to be shorter than 30 minutes for trauma patients with hemorrhage to effectively save lives.[1].

The importance of rapid transport, early truncal hemorrhage control and whole blood transfusion is also widely recognized in the civil world[2].  Furthermore, it is recognized that the peak time to death after severe truncal injury is within 30 minutes of injury. However, when adding prehospital transport time, time spent in the emergency department, followed by the time in the operating room, it can take 2.1 hours to achieve definitive truncal hemorrhage control[2].

There is still potential to reduce the number of both preventable combat and civil trauma deaths further. Data indicates that this among other things, will require the ability to provide on-target blood transfusion and further shortening the time from injury to surgery to as little as twenty minutes[1].

Or maybe we should aim at just ten minutes, which is what a study of the association of early administration of packed red blood cells (pBRC) and mortality indicated[3]. The study concluded that delays in time to pRBC administration of as short as 10 minutes were associated with increased odds of death for patients receiving ultra-early pRBC transfusion[3]. There is no doubt that time is of the essence when it comes to treatment of trauma patients, and it is safe to say that when it comes to survival of hemorrhage every minute counts.

 

REFERENCES

[1] Death Ignores the Golden Hour, The Argument for Mobile, Farther-Forward Surgery
https://www.armyupress.army.mil/Portals/7/military-review/Archives/English/MA-20/Beldowicz-Golden-Hour.pdf

[2] Transport Time and Preoperating Room Hemostatic Interventions Are Important: Improving Outcomes After Severe Truncal Injury
https://pubmed.ncbi.nlm.nih.gov/29474326/

[3] Shorter times to packed red blood cell transfusion are associated with decreased risk of death in traumatically injured patients
https://journals.lww.com/jtrauma/Abstract/2016/09000/Shorter_times_to_packed_red_blood_cell_transfusion.8.aspx

 

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).