Blood Administration in Helicopter Emergency Medical Services Patients Associated With Hypothermia

Air Medical Journal: Volume 32, Issue 1 , Pages 47-51, January 2013

The infusion of packed red blood cells (PRBCs) in the severely injured patient is not a new practice. It is a potentially lifesaving procedure although it is not without inherent risk. This practice in the helicopter emergency medical services (HEMS) has not been examined in the literature. The authors wanted to attempt to determine the factors associated with hypothermia (ie, < 35°C), including the transfusion of O negative blood.

© Gary Wilson/ Pre-hospital Research Forum

This was a retrospective review using the trauma registry on all patients who arrived at the authors’ rural level 1 trauma center by HEMS from January 1, 2005, through June 30, 2009 [Dartmouth-Hitchcock Medical Center, Lebanon, NH]. Patient temperature on arrival was compared for patients with and without hypothermia transported by the HEMS service.

During the study period, there were 707 HEMS transports. Sixty (8.5%) were hypothermic, and 30 (4.2%) received PRBCs. There was a high likelihood of PRBC patients with hypothermia (odds ratio = 6.27; 95%).

The authors found that HEMS trauma patients who have received blood are more likely to arrive hypothermic (ie, < 35°C). The clinical impact of giving PRBCs in the HEMS prehospital setting was not determined.

http://www.airmedicaljournal.com/article/S1067-991X(12)00052-1/abstract?elsca1=etoc&elsca2=email&elsca3=1067-991X_201301_32_1&elsca4=emergency_medicine