Blood Administration in Haemorrhagic shock within EMS systems

This episode continues our series on traumatic bleeding, focusing
on the use of blood transfusions in prehospital settings. While
blood transfusions are life-saving for haemorrhagic shock,
evidence on prehospital blood use is mixed. Civilian and military
studies show improved outcomes with prehospital blood, but the
2022 RePHILL trial found no superiority over sodium chloride for
trauma-related hemorrhagic shock -
https://www.thebottomline.org.uk/summaries/icm/rephill/. Despite
this, haemostatic resuscitation has evolved to be the standard
care for bleeding-induced shock in the UK. Currently, only
physicians in HEMS systems can administer prehospital blood under
UK paramedic guidelines, with paramedics limited to using sodium
chloride.


The 2007 Manchester Arena bombing inquiry considered frontline
ambulances carrying blood products but deemed it infeasible for
clinical and logistical reasons. It recommended that specialist
teams, such as the Hazardous Area Response Team (HART), carry
freeze-dried plasma. Southwestern Ambulance Service HART has
since trialed Lyoplas.


This episode discusses paramedic-administered blood products
outside of HEMS systems, featuring Dr. Peter Chesney, Lt. Col.
(retired) Randy Shaffer, and Dr. Chesney, a pediatric emergency
physician and medical director in South Florida. Lt. Col.
Shaffer, a former Emergency and Trauma nurse in the U.S. Army,
established prehospital programs and walking blood banks during
her deployments and has since worked on regional blood coalition
initiatives. Dr. Chesney, a seasoned trauma surgeon, has received
numerous accolades, including the Outstanding Clinical Research
Achievement Award, and co-founded the international damage
control resuscitation educational program.





This episode is sponsored by the International Critical
Care Paramedic Group (ICCPG):





The ICCPG are dedicated to advancing global Paramedicine through
knowledge sharing and improved communication. Join their second
conference on January 30, 2025, following the success of their
2022 event, which united over 600 paramedics worldwide. This
virtual event will feature detailed case studies and in-depth
clinical, training, leadership, and research discussions. Don't
miss this opportunity to connect with peers and learn from
international experts. For more details, contact Christian Wiggin
at christian.wiggin@collegeofparamedics.co.uk








This podcast is sponsored by the University of
Hertfordshire.


The University of Hertfordshire’s MSc Advanced Paramedic Practice
offers flexible, part-time study with some online options.
Students can choose between two pathways: Primary and Urgent Care
or Emergency and Critical Care. The program includes modules in
leadership, coaching, and independent prescribing. Expert,
research-active staff with national and international profiles
deliver innovative teaching using online, VR, and simulation
technology. With over 25 years of heritage, the program promises
excellent career prospects and opportunities for further research
through Masters by research and PhDs. Please see here for further
details:


https://www.herts.ac.uk/courses/postgraduate-masters/msc-advanced-paramedic-practice2?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic