title: Plasma first in the field for postinjury hemorrhagic shock.
abstract: Hemorrhage is the most preventable cause of death in civilian and military trauma, and despite tremendous advances in patient transport in the field, survival within the first hour has changed little over the past 40 years. The pathogenesis of trauma-induced coagulopathy is multifactorial, but most authorities believe there is an early depletion of clotting factors. While fresh frozen plasma delivered early in the emergency department has been shown to be beneficial, the rapid onset of trauma-induced coagulopathy suggests advancing this concept to the scene may improve patient outcome. The purpose of this report was to describe the rationale and design of a randomized trial to test the hypothesis that prehospital "plasma-first" resuscitation will benefit the critically injured patient. The rationale includes the possibility that plasma-first resuscitation may be advantageous beyond direct effects on clotting capacity. The study design is based on a ground ambulance system that allows rapid prehospital thawing of frozen plasma.
authors: *Department of Surgery, Denver Health Medical Center, Denver, Colorado; and †Department of Surgery, University of Colorado-Denver, Aurora, Colorado.
authors: Ernest E
authors: EE
authors: Moore
authors: Theresa L
authors: TL
authors: Chin
authors: Michael C
authors: MC
authors: Chapman
authors: Eduardo
authors: E
authors: Gonzalez
authors: Hunter B
authors: HB
authors: Moore
authors: Christopher C
authors: CC
authors: Silliman
authors: Kirk C
authors: KC
authors: Hansen
authors: Angela
authors: A
authors: Sauaia
authors: Anirban
authors: A
authors: Banerjee
mesh_terms: D001777:Blood Coagulation; D016913:Blood Component Transfusion / Q000379:methods*; D004632:Emergency Medical Services; D004635:Emergency Medicine / Q000379:methods; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D008889:Military Personnel; D010949:Plasma / Q000737:chemistry*; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States; D014947:Wounds and Injuries / Q000628:therapy