The main objective of this study is to evaluate the use of RBC, FDP, WB in the treatment of exsanguinating patients by physician-staffed emergency medical services in Norway, with focus on prehospital transfusion complications and safety.
This study evaluates prehospital transfusion therapy in exsanguinating patients treated by physician-staffed emergency medical services in Norway, with the following main questions: I. Are out-of-hospital transfusions associated with an increase in adverse transfusion events compared to inhospital transfusions? II. Is out-of-hospital physician administration of plasma or blood products in exsanguinating patients feasible? III. Are patients in need of blood product transfusion possible to identify and transfuse in the prehospital phase/environment? IV. Are out-of-hospital transfusion practices associated with increased waste of blood products? All patients in haemorrhagic shock needing volume replacement and receiving prehospital transfusion of blood products will be included, if they fulfill the listed criteria below: * Patients with mechanism of injury compatible with severe haemorrhage and/or haemorrhagic shock (e.g. penetrating torso injury, visible massive bleeding) * Radial pulse \> 100 beats/min or absent/weak radial pulse * Systolic blood pressure (SBP) \< 90 mmHg * Altered mental status (reduced GCS) in the absence of head injury or known intoxication Patients with known previous serious allergic reactions to blood product transfusions or patients who refuse blood products on religious grounds (e.g. Jehovah´s Witness) will be excluded.
Study Type
OBSERVATIONAL
Enrollment
72
Fresh produced RBC
Fresh produced WB
(LyoPlas N-w (German Red Cross)
Sørlandet Hospital HF
Arendal, Norway
Haukeland University Hospital
Bergen, Norway
Innlandet Hospital Trust
Brumunddal, Norway
Vestre Viken Hospital Trust
Drammen, Norway
adverse transfusion reactions
Fraction of patients with suspected adverse transfusion reactions after administration of plasma and/or blood products.
Time frame: 24 hours
patients included
Fraction of patients fulfilling inclusion criteria with prehospital administration of blood products
Time frame: 24 hours
units not used
Fraction of prepared plasma or blood units not used.
Time frame: 24 hours
Number of adverse events
Number of adverse events (e.g. transfusion related complications or reactions (first 24 hrs))
Time frame: 24 hours
Type of adverse events
Type of adverse events (e.g. transfusion related complications or reactions (first 24 hrs))
Time frame: 24 hours
number of transfusion
Number of transfusions given prehospital and inhospital (first 24 hrs)
Time frame: 24 hours
type of transfusion
type of transfusions given prehospital and inhospital (first 24 hrs)
Time frame: 24 hours
Systolic blood pressure (SBP)
Systolic blood pressure (SBP) on scene and at admission hospital
Time frame: 24 hours
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Helse Førde
Førde, Norway
Oslo University Hospital
Oslo, Norway
Helse Stavanger HF
Stavanger, Norway
University Hospital of North Norway
Tromsø, Norway
St Olav University Hospital
Trondheim, Norway
heart rate (HR)
heart rate (HR) on scene and at admission hospital
Time frame: 24 hours
Glasgow Coma Score (GCS)
Glasgow Coma Score (GCS) on scene and at admission hospital
Time frame: 24 hours
Respiratory rate (RR)
Respiratory rate (RR) on scene and at admission hospital
Time frame: 24 hours
Pulse oximeter (SPO2)
Pulse oximeter (SPO2) on scene and at admission hospital
Time frame: 24 hours
response time (minutes)
Physician staffed emergency medical services response (in minutes) from dispatch to arrival on-scene
Time frame: 24 hours
on-scene time (minutes)
Time (in minutes) from emergency medical services arrival on-scene until patients leaves the scene or is pronounced dead on-scene
Time frame: 24 hours
transport time (minutes)
Time (in minutes) from the patients leaves the scene until patient arrives in hospital
Time frame: 24 hours
Number of surgical interventions
Number of surgical interventions (first 24 hrs)
Time frame: 24 hours
Type of surgical interventions
type of surgical interventions (first 24 hrs)
Time frame: 24 hours