Prehospital Transfusion Medicine: Components, Compatibility, and Whole Blood

Recent years have seen increased discussion surrounding the benefits of damage control resuscitation, prehospital transfusion (PHT) of blood products, and the use of whole blood over component therapy. Concurrent shortages of blood products with the desire to provide PHT during air medical transport have also prompted reconsideration of the traditional approach of administering RhD-negative (RhD-) red-cell-containing blood products first line to females of childbearing potential (FCPs). This session will cover the types of blood products available for prehospital transfusion, the concept of balanced transfusion of blood products, ABO and Rh compatibility, the consequences of incompatible transfusions including hemolytic transfusion reactions and hemolytic disease of the fetus and newborn, the role of RhIG after a prehospital transfusion, breaking the compatibility rules through the use of Whole Blood and Group A Plasma, the evidence supporting the use of whole blood over component therapy, landmark trials in prehospital transfusion, and the growing number of prehospital low titer O positive whole blood programs in the United States.