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INTRODUCTIONHemorrhage is responsible for over 40% of all trauma‐related deaths, with nearly half occurring in the prehospital setting.1,2 Among major trauma patients who reach emergency departments alive, in‐hospital transfusion of a high ratio, of at least 1 unit of plasma to every 2 units of red blood cells (RBCs), has been associated with survival.3 This transfusion of plasma can prevent or treat the acute traumatic coagulopathy (ATC) that is observed in around 25% of major trauma patients.4,5 Patients with ATC are three to four times more likely to die and up to eight times more likely to die within the first 24 h.6–9 ATC on admission is also associated with development of acute kidney injury and multiple organ failure, fewer ventilator‐free days, and longer stays in the intensive care unit (ICU) and hospital.10One treatment of ATC is the infusion of fresh‐frozen plasma (FFP). However, there is limited evidence to support the resource investment necessary to provide FFP in the prehospital environment. The two randomized controlled trials using prehospital FFP differed in their conclusions.11,12 An alternative to FFP that is particularly suitable for prehospital use is freeze‐dried plasma, but a recent United Kingdom trial of freeze‐dried plasma and RBCs compared to crystalloid in
Academic Emergency Medicine – Wiley
Published: Oct 1, 2023
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