Prehospital Transfusion of Low-Titer O + Whole Blood for Severe Maternal Hemorrhage: A Case Report.
Ryan K NewberryC J WincklerRyan LuellwitzLeslie GreebonElly XenakisWilliam BullockMichael StringfellowJulian MappPublished in: Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors (2019)
Introduction: Beginning in 2017, multiple stakeholders within the Southwest Texas Regional Advisory Council for Trauma collaborated to incorporate cold-stored low-titer O RhD-positive whole blood (LTO + WB) into all phases of their trauma system, including the prehospital phase of care. Although the program was initially focused on trauma resuscitation, it was expanded to included non-traumatic hemorrhagic shock patients that may benefit from whole blood resuscitation.Case Report: We report the case of a patient with severe maternal hemorrhage secondary to placenta accreta who received a prehospital transfusion of LTO + WB. We believe this to be the first reported case of post-partum hemorrhage resuscitated out of hospital with whole blood.Discussion: This case highlights the potential benefits of a prehospital whole blood program as well as the controversy surrounding a LTO + WB program that includes females of childbearing age.
Keyphrases
- cardiac arrest
- trauma patients
- cardiopulmonary resuscitation
- quality improvement
- case report
- end stage renal disease
- healthcare
- cardiac surgery
- newly diagnosed
- spinal cord injury
- ejection fraction
- emergency medical
- early onset
- birth weight
- chronic kidney disease
- emergency department
- pregnancy outcomes
- palliative care
- peritoneal dialysis
- pregnant women
- pain management
- room temperature
- physical activity
- weight loss
- electronic health record