Background

Early transfusion of patients with major traumatic haemorrhage may improve survival. This study aims to establish the feasibility of freeze-dried plasma transfusion in a Helicopter Emergency Medical Service in the United Kingdom.

Method

A retrospective observational study of major trauma patients attended by Kent, Surrey and Sussex Helicopter Emergency Medical Service and transfused freeze-dried plasma since it was introduced in April 2014.

Results

Of the 1873 patients attended over a 12-month period before its introduction, 79 patients received packed red blood cells (4.2%) with a total of 193 units transfused. Of 1881 patients after the introduction of freeze-dried plasma, 10 patients received packed red blood cells only and 66 received both packed red blood cells and freeze-dried plasma, with a total of 158 units of packed red blood cells transfused, representing an 18% reduction between the two 12-month periods. In the 20 months since its introduction, of 216 patients transfused with at least 1 unit of freeze-dried plasma, 116 (54.0%) patients received both freeze-dried plasma and packed red blood cells in a 1:1 ratio. Earlier transfusion was feasible, transferring the patient to hospital prior to transfusion would have incurred a delay of 71 minutes (IQR 59-90).

Conclusion

Pre-hospital freeze-dried plasma and packed red blood cell transfusion is feasible in a 1:1 ratio in patients with suspected traumatic haemorrhage. The use of freeze-dried plasma as a first line fluid bolus reduced the number of pre-hospital packed red blood cell units required and reduced the time to transfusion.