Helicopter In-flight Resuscitation with Freeze-dried Plasma of a Patient with a High-velocity Gunshot Wound to the Neck in Afghanistan - A Case Report.
Massive hemorrhage with coagulopathy is one of the leading causes of preventable death in the battlefield. The development of freeze-dried plasma (FDP) allows for early treatment with coagulation-optimizing resuscitation fluid in the prehospital setting. This report describes the first prehospital use of FDP in a patient with carotid artery injury due to a high-velocity gunshot wound (HVGSW) to the neck. It also describes in-flight constitution and administration of FDP in a Medevac Helicopter. Early administration of FDP may contribute to hemodynamic stabilization and reduction in trauma-induced coagulopathy and acidosis. However, large-scale studies are needed to define the prehospital use of FDP and other blood products.
1Karolinska Institutet/Södersjukhuset,Department of Clinical Science and Education,Section of Anesthesiology and Intensive Care,Stockholm,Sweden.
Mikael
M
Gellerfors
2SAE Medevac Helicopter,Armed Forces Centre for Defense Medicine (FörmedC),Gothenburg,Sweden.
Joacim
J
Linde
4Karolinska Institutet,Department of Physiology,Section of Anesthesiology and Intensive Care,Stockholm,Sweden.
Dan
D
Gryth
D000328:Adult; D000346:Afghanistan; D000401:Aircraft; D016913:Blood Component Transfusion; D005612:Freeze Drying; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000628:therapy*; D010949:Plasma; D012151:Resuscitation / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000628:therapy*
BP blood pressure; FDP freeze-dried plasma; FFP fresh frozen plasma; FLYP French Lyophilized Plasma; HR heart rate; HVGSW high-velocity gunshot wound; IV intravenous; RBC red blood cell; RR respiratory rate; fluid resuscitation; military medicine; plasma; prehospital; trauma