title: Characteristics and outcomes of patients administered blood in the prehospital environment by a road based trauma response team.
abstract: OBJECTIVE
  To describe the characteristics, clinical interventions and the outcomes of patients administered packed red blood cells (pRBCs) by a metropolitan, road based, doctor-paramedic trauma response team (TRT).
  
  
  METHODS
  A retrospective cohort study examining 18 months of historical data collated by the Queensland Ambulance Service TRT, the Pathology Queensland Central Transfusion Laboratory, the Royal Brisbane and Women's Hospital and the Princess Alexandra Hospital Trauma Services was undertaken.
  
  
  RESULTS
  Over an 18-month period (1 January 2011 to 30 June 2012), 71 trauma patients were administered pRBCs by the TRT. Seven patients (9.9%) died on scene and 39 of the 64 patients (60.9%) transported to hospital survived to hospital discharge. 57 (89.1%) of the transported patients had an Injury Severity Score (ISS) > 15, with a mean ISS, Revised Trauma Score (RTS) and Trauma-Injury Severity Score of 32.11, 4.70 and 0.57, respectively. No patients with an RTS < 2 survived to hospital discharge. 53 patients (82.8%) received additional pRBCs in hospital with 17 patients (26.6%) requiring greater than 10 units pRBCs in the first 24 h. 47 patients (73.4%) required surgical or interventional radiological procedures in the first 24 h.
  
  
  CONCLUSIONS
  There is a potential role for prehospital pRBC transfusions in an integrated civilian trauma system. The RTS calculated using the initial set of observations may be a useful tool in determining in which patients the administration of prehospital pRBC transfusions would be futile.
authors: Queensland Ambulance Service, Brisbane, Queensland, Australia.|Department of Emergency Medicine, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.|Department of Emergency Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
authors: Daniel
authors: D
authors: Bodnar
authors: Queensland Ambulance Service, Brisbane, Queensland, Australia.|Department of Emergency Medicine, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.
authors: Stephen
authors: S
authors: Rashford
authors: Department of Emergency Medicine, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.
authors: Catherine
authors: C
authors: Hurn
authors: Queensland Ambulance Service, Brisbane, Queensland, Australia.
authors: Jamie
authors: J
authors: Quinn
authors: Queensland Ambulance Service, Brisbane, Queensland, Australia.
authors: Lachlan
authors: L
authors: Parker
authors: Queensland Ambulance Service, Brisbane, Queensland, Australia.|Department of Emergency Medicine, The Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
authors: Katherine
authors: K
authors: Isoardi
authors: Pathology Queensland Central Transfusion Laboratory, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia.
authors: Sue
authors: S
authors: Williams
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D004632:Emergency Medical Services / Q000458:organization & administration*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000628:therapy*; D011793:Queensland; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D016896:Treatment Outcome
keywords: Trauma; emergency ambulance systems; pre-hospital; resuscitation