如果你建好了，他们就会来——院前全血计划的实施

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-08-21 DOI:10.1016/j.amjsurg.2025.116587

R.B. Fransman , C.H. Meyer , J. Nguyen , S.R. Todd , E.R. Benjamin , L de leon Castro , S. Collins , L. Pack , A. Schwartz , B. Spaeth , M. Thorton , M.S. McCain , J. Sikora , L. Kumar

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引用次数: 0

摘要

我们试图开发、实施和评估一个城市院前全血（PH-WB）计划。方法利用回顾性热图数据，将携带PH-WB的快速反应车辆（qrv）战略性地部署在全市各地，并采用动态部署的方式进行调度。患者入选标准为年龄≥15岁，创伤机制，收缩压≤90mmhg。前瞻性数据收集于2025年3月21日至6月21日。结果375例患者输注PH-WB 588单位，55%患者输注1单位。输血后，从现场到ED到达，平均收缩压增加28 mmHg，脉搏减少19 bpm。24小时和30天的总生存率分别为83%和80.8%。本研究展示了大规模PH-WB项目的成功实施，利用创造性的策略在有限的资源下覆盖了一个大的集水区。初步结果记录了PH-WB的安全交付，院前现场时间变化最小，现场全血过期率为0%，以及方案的高依从性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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If you build it, they will come - Implementation of a prehospital whole blood program

Introduction

We sought to develop, implement and evaluate an urban prehospital whole blood (PH-WB) program.

Methods

Using retrospective heat map data, Quick Response Vehicles (QRVs) carrying PH-WB were strategically placed throughout the city and dispatched using dynamic deployment. Patient inclusion criteria were age ≥15 years, traumatic mechanism, and SBP ≤90 mmHg. Prospective data were collected between 3/21-6/21/2025.

Results

375 patients were transfused 588 units of PH-WB, with 55 % receiving >1 unit. With transfusion, the average SBP increased by 28 mmHg and pulse decreased by 19 bpm from field to ED arrival. The overall survival at 24-h and 30-days was 83 % and 80.8 %, respectively.

Conclusion

This study demonstrates the successful implementation of large-scale PH-WB program utilizing creative strategies to cover a large catchment zone with limited resources. Preliminary results document safe delivery of PH-WB, minimal variation in pre-hospital scene times, 0 % expiration rate of whole-blood in the field and high compliance with protocols.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.