Pilot project puts blood plasma in ambulances

[SteveC7010 58]

http://wtvr.com/2014/05/13/richmond-ambulances-to-carry-plasma-a-first-for-the-nation/

This might finally change the way we treat trauma victims.

[sympathomedic 383]

Well Hot Damn! I had always hoped something would come along to allow us to give SOMETHING that would transport oxygen. I thought it would be some new fluid. I would like to see the cost and protocols for this. I really really hope it works. This could be the biggest advance since the AED.

[mvfire8989 22]

Well Hot Damn! I had always hoped something would come along to allow us to give SOMETHING that would transport oxygen. I thought it would be some new fluid. I would like to see the cost and protocols for this. I really really hope it works. This could be the biggest advance since the AED.

Just to be clear this article is talking about blood plasma, it does not have a major role in transporting oxygen to tissues. This is a product with plasma proteins and coagulation factors only. It does not contain red cells, white cells or platelets.

[v85 212]

Still, blood plasma is probably better then normal saline or lactated ringers for fluid resuscitation and shock treatment

[Bnechis 3,961]

30 years ago we were carrying Albumin. I do not think it was ever even used. Just cost money & would expire in the rig.

[velcroMedic1987 330]

This extensive trial, funded by the Department of Defense, will be in Richmond, Pittsburgh and Denver, cities known for top-notch EMS and trauma systems, as well as strong partnerships with local hospitals.

That rules out seeing this in NY.

[50-65 205]

Not withstanding my age impaired memory, I seem to recall that an air medical system in Texas was doing something similar to this years ago. I don't know how it worked for them.

[Bnechis 3,961]

Even if this brings a great outcome to an individual patient(s), I suspect the program is not very likely to be successful. How many systems do enough serious trauma that this is needed, but more important is how many ambulances are these calls being divided by? Also in many high volume systems, your transport times to a trauma center are often only a few minutes.

[mvfire8989 22]

Still, blood plasma is probably better then normal saline or lactated ringers for fluid resuscitation and shock treatment

I have no idea what the protocols for this study are, that being said in the hospital environment FFP is a relatively small volume product and in current use is most often used to correct factor deficiencies that can develop in an acute hemorrhage. Many trauma centers have a massive transfusion protocol that calls for the replacement of plasma and platelets when transfusing more than 5 units of packed rbcs. What I imagine that this study is looking at is if earlier normalization of pt/ptt would be beneficial to patients. I would be surprised if they are looking to replace crystalloids for fluid resuscitation. There has been several large studies that have looked at doing that with various colloid fluids like albumin and hydroxyethyl starch but to date they have not been shown to be superior and may have their own problems. Like Bnechis mentioned transport times for the most part are short in metro areas where this would be likely to be used, getting some NS or LR running and diluting their blood is the best in the short term. That way the volume the patient is losing is not all blood, and they lose less oxygen carrying capacity.

[Ga-Lin 86]

Still, blood plasma is probably better then normal saline or lactated ringers for fluid resuscitation and shock treatment

30 years ago we were carrying Albumin. I do not think it was ever even used. Just cost money & would expire in the rig.

I also remember having Albumin on the bus, never used it. Most systems and studies stress a quick transport decision and rapid transport, preferablly to a trauma center, not field fluid resusitation. Trauma patients need only one thing, a surgeon & an operating room (OK two things), not a medic trying to get that 20ga line on a multisystem trauma. Years back, a study was done in NYC, to keep this short, ALS had higher mortality than the BLS crews. Why, because BLS were "scooping and shooten" to the hospitals. ALS units were doing to much "medic" stuff.