The effects of prehospital plasma on patients with injury

Abstract

Use of plasma-first resuscitation in the helicopter system creates a field ready, mobile blood bank, allowing early resuscitation of the patient demonstrating need for massive transfusion. There was early treatment of trauma-induced coagulopathy. Although there was not a survival benefit demonstrated, there was resultant damage control resuscitation extending to 24 hours in the plasma-first cohort.

Emergency use of prethawed Group A plasma in trauma patients

“…11 Plasma is unavailable in 19 of the 22 trauma centers within our region. 11 Our institution is, therefore, the main supplier of emergency release plasma to our region. We receive specific requests for transport via air ambulance purely for the early initiation of plasma resuscitation.…”

“…With this program, we have been able to show an improved plasma-to-RBC ratio. 11 We did not perform anti-B agglutinin titer assays on units of transfused Group A plasma. Not only is this an expensive process but also is not routine practice in the manufacturing procedure for platelets despite 40% of the transfusions being incompatible.…”

“…The goal of this program was to combat the geographic plasma deficit inherently present in rural trauma. 11,12 During the development of this program, concerns were raised about the depletion of the universal plasma donor; calculations performed to predict future Group AB plasma need, based on historical use, demonstrated that expansion of the emergency use of Group AB plasma was unsustainable. To alleviate the supply concern, we elected to use Group A plasma for all emergency release and prethawed plasma transfusions, both prehospital and in-hospital, and transition to group-compatible transfusions once the ABO group was known.…”

Advances in damage control resuscitation and surgery: implications on the organization of future military field forces

“…Even so, advocates of remote DCR point out that there is evidence to suggest that prehospital administration of plasma may be beneficial. 35 The logistical challenges involved with deploying thawed plasma to the battlefield, however, have caused proponents of remote DCR to look for alternative solutions.…”

Never-frozen liquid plasma blocks endothelial permeability as effectively as thawed fresh frozen plasma

“…6,11,12 TP is an AABB (formerly known as the American Association of Blood Banks)Yapproved product and a common form of plasma administered. TP is the thawed form of FFP and can be refrigerated at 1-C to 6-C for 5 days.…”