The Impact of Prehospital Blood Transfusion for Trauma Patient with Haemorrhagic Shock

Abstract

Trauma significantly contributes to the annual global mortality rate. One of the major causes of death resulting from traumatic injury is haemorrhagic shock. Early resuscitation with blood and blood products in low ratios is recommended by the Advanced Trauma Life Support (ATLS) in patients with evidence of Class III and IV haemorrhage. Therefore, the aim of this dissertation is to determine the impact of Prehospital Blood Products Transfusion (PHBT) on mortality rate compared to crystalloid solutions in trauma patients experiencing haemorrhagic shock. Method: A systematic literature search was performed across three electronic databases (Ovid Medline, Embase Advanced Search and CINAHL Complete (EBSCO) database) for data published between 01 January 2013 to 20 October 2023. Eligibility criteria included randomised controlled trials (RCTs) and comparative cohort study comparing prehospital blood products transfusion with standard care. All included studies were screened and assessed utilising the Critical Appraisal Skills Programme (CASP) tool to evaluate their quality. Results: From an initial 2425 articles collected, 870 duplicates were removed, and a further 1534 were excluded. Following title and abstract screening of the 21 studies that has a full-text review, six studies met the predefined inclusion criteria. From these studies, PHBT did not cause any reduction in mortality rates compared with crystalloid fluids. Conclusion: While PHBT is increasingly being adopted as an intervention in pre-hospital settings, the results from the systematic literature search did not reveal a reduction in mortality rates in favour of PHBT recipients compared to crystalloid solution. Conducting a RCT would be required to fully address the proposed research question