Prehospital blood transfusion in Brazil: results of the first year of implementation in an emergency medical service

Abstract

Introduction: Hemorrhagic shock is the main cause of death in the prehospital environment, which highlights the need to standardize measures aiming at bleeding control and volume replacement in this environment. In Brazil, the first prehospital packed red blood cell transfusion service started in September 2020, in Bragança Paulista, state of São Paulo. Objectives: Describe the trends and characteristics of patients who received prehospital transfusions prior to hospital treatment during the first year of operation. Methods: A retrospective data review was made of all patients who received transfusions from the mobile intensive care unit in Bragança Paulista over one year. Results: In this period, 19 patients were transfused. Since activation, the average response time was 20 min. The mean shock indexes before and after blood transfusion were 2.16 and 1.1, respectively. During the course of the 1st year of prehospital transfusions, no blood was wasted and there were no adverse effects. Conclusion: Introduction of the prehospital packed red blood cell transfusion service was successful, with significant improvement in hemodynamic parameters.

Keywords

• Prehospital transfusion service
• Patient blood management
• Massive transfusion
• Red cell components
• Transfusion strategy