title: Prehospital blood transfusion versus crystalloid alone in the air medical transport of trauma patients.
abstract: BACKGROUND
  Differences in prehospital resuscitation measures and outcomes of trauma patients transported by two air medical programs were assessed comparing the prehospital administration of crystalloid only (Group A) with the administration of 2 liters of crystalloid followed by blood (Group B).
  
  
  METHODS
  A 1-year retrospective review of flight and hospital records of patients taken to Level I trauma centers by two separate air medical programs was completed. Physiologic variables, total fluids infused, and flight times were compared.
  
  
  RESULTS
  Thirty-one patients (Group A) received crystalloids in flight, and 17 patients received in-flight blood (Group B). No statistical differences were found between the two groups when comparing age, ISS, PS, RTS, GCS, survival, and total fluid volume. Group B had statistically greater mean flight times compared with Group A (P < .05). A difference was demonstrated between groups A and B in pH and HCO3 measurements (P < .05), with Group B presenting in a more acidotic state on admission to the hospital.
  
  
  CONCLUSIONS
  Patients with lengthy flight times, despite the administration of blood products, presented to the trauma center more acidotic than trauma patients receiving only crystalloid. The true impact of blood products on outcome could not be demonstrated because of statistical differences in flight times between the groups. A multicenter study matching flight times, head injury status, and flight type of assess benefit of prehospital utilization of blood products is warranted.
authors.affiliation: Erlanger Medical Center, University of Tennessee, Chattanooga, Tenn., USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Sumida
authors.forename: K
authors.initials: K
authors.lastname: Quinn
authors.forename: P L
authors.initials: PL
authors.lastname: Lewis
authors.forename: Y
authors.initials: Y
authors.lastname: Jones
authors.forename: D E
authors.initials: DE
authors.lastname: Barker
authors.forename: D L
authors.initials: DL
authors.lastname: Ciraulo
authors.forename: V
authors.initials: V
authors.lastname: Cowell
authors.forename: S
authors.initials: S
authors.lastname: Luk
authors.forename: D
authors.initials: D
authors.lastname: Murphy
authors.forename: L
authors.initials: L
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D017732:Air Ambulances; D001803:Blood Transfusion / Q000379:methods* / Q000592:standards*; D000077324:Crystalloid Solutions; D006801:Humans; D007552:Isotonic Solutions; D009104:Multiple Trauma / Q000453:epidemiology / Q000628:therapy*; D010952:Plasma Substitutes / Q000008:administration & dosage*; D015532:Rehydration Solutions / Q000008:administration & dosage*; D012189:Retrospective Studies; D018570:Risk Assessment; D065227:Transfusion Reaction; D014187:Transportation of Patients / Q000379:methods; D014193:Trauma Centers; D016896:Treatment Outcome; D014481:United States
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D015532:Rehydration Solutions