ABSTRACTS
National Review of Motor Vehicle Collision Patients Receiving Pre-hospital Blood in 2024Author: Corey Youells | Regional Manager of Clinical Operations | Global Medical Response Associate Authors: Sanders, Ari Gopani, Mark MS DS Powell, Johnathon R.
Introduction: Pre-hospital blood transfusion is a recent addition to emergency medical services’ (EMS) skill set, improving intervention capabilities of EMS clinicians responding to life threatening trauma. Delivery of pre-hospital blood to patients involved in motor vehicle collisions (MVC) is not well documented, with suspected varying clinical indication criteria. Our objective was to describe patient characteristics of those receiving blood after sustaining MVC related injuries in a national EMS dataset. Methods: We performed a retrospective, descriptive evaluation of adult MVC patients who received blood in 2024 from the ImageTrend Collaborate dataset. We included 9-1-1 dispatched EMS activations identified as MVCs using injury, dispatch, impression, situation, protocol, and scene elements. We identified blood administration using any blood-related product delivery documented in medication or procedure fields. We further collected patient demographics (e.g., age, gender), activation characteristics (e.g., mechanism of injury, type of service), first recorded vital signs (e.g., heart rate, systolic blood pressure), and first recorded composite vital metrics (mean arterial pressure [MAP], shock index [SI], reverse SI*Glasgow Coma Score [rSIG]). We calculated descriptive statistics (n, %; median, interquartile range) and used Stata 18 MP for all analyses. Results: We included 620,150 MVC EMS activations in 2024 for analysis. Of these, blood or blood products were administered in 1,087 activations. Raw proportions of those receiving blood, compared to those not, were more heavily white (77% vs 46%), male (67% vs. 52% ), and older (44 [28-61] vs 36 [23-55]). Activations receiving blood were primarily transported by air (96%) and had blunt (92%) injury types. First observed vital signs and composite metrics showed variability by blood delivery: heart rate (blood: 101 [73-123], no blood: 93 [79-108]), systolic blood pressure (blood: 96 [67-122], no blood: 135 [117-152]), MAP (blood: 81 [53-105], no blood: 93 [90-114]), Glasgow Coma Scale (blood: 12 [3-15], no blood: 15 [15-15]), SI (blood: 1.00 [1.00-1.01], no blood: 0.72 [0.60-0.96]), rSIG (blood: 9.21 [3.0-14.73], no blood: 21.07 [16.48-25.38]). Conclusion: This evaluation demonstrates variability in MVC patients receiving blood from EMS clinicians across patient characteristics.
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