Nationwide pediatric prehospital blood product use after motor vehicle crashes 2020-2023.
Transfusion · 2026-02-12 · Registry study
Abstract
BACKGROUND: Previous studies suggest that in children with hemorrhagic shock following injury, prehospital blood transfusion improves survival. Quantifying and understanding the current demand for blood transfusion will help us improve the use and availability of prehospital blood for pediatric patients. This study sought to describe the current demand for and utilization of prehospital blood resuscitation following motor vehicle crash (MVC) in pediatric trauma populations from 2020 to 2023. STUDY DESIGN AND METHODS: Hypotensive patients ≤14 years after MVC included in the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 were identified. Hemodynamic instability was based on age-defined systolic blood pressure and heart rate parameters. Total number and percentage of children who received prehospital blood transfusion, including components or whole blood, were calculated. RESULTS: The database included 391,764 children involved in an MVC. Of these, 1913/391,764 (0.5%) were potentially eligible for prehospital blood transfusion based on prehospital hemodynamic status, yet of the 1913 patients, only 39/1913 (2%) received prehospital blood. Eligible patients were generally older than 10 years (64%) and MVCs occurred in urban areas (77%). DISCUSSION: Only 2% of hemodynamically unstable pediatric MVC patients received prehospital blood. Prehospital blood resuscitation is underutilized in pediatric MVC populations, suggesting an urgent need for focused evaluation to identify barriers and promote increased utilization.
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Tags
Blood products · Children · Fluids & blood · Urban
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