Mel does a short summary of the recent PAMPer Trial of Plasma vs. usual care in hemorrhagic shock in the pre-hospital setting. Based on the paper Sperry et. al. NEJM July 26th 2018 379;4 pp315.
I was disappointed that they included HEMS agencies that did not carry blood and were giving balanced fluids. We already know this is an inferior product to blood or possibly plasma. Why not just compare blood to plasma?
Sorry to keep sending multiple comments on this but I read this article very closely and was a flight physician at a trial sites. Trying to get blood bank to allow a HEMS agency to carry blood alone is a chore. Trying to get them to release an even more critical product that has a shelf live of only a few days is going to be near impossible. Not that we should not fight for the best care of our patients but we may need to choose our battles. I really think the location that we as EM practitioners push for this would be in the trauma bay as the first in fluid in sick trauma patients. Having the product on site in the Trauma bay is going to be a much more realistic fight with blood bank than in our HEMS agencies.
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William K. - August 24, 2018 6:14 PM
I was disappointed that they included HEMS agencies that did not carry blood and were giving balanced fluids. We already know this is an inferior product to blood or possibly plasma. Why not just compare blood to plasma?
William K. - August 24, 2018 6:17 PM
Remember many of these HEMS agencies already carried blood.
William K. - August 24, 2018 6:25 PM
Sorry to keep sending multiple comments on this but I read this article very closely and was a flight physician at a trial sites. Trying to get blood bank to allow a HEMS agency to carry blood alone is a chore. Trying to get them to release an even more critical product that has a shelf live of only a few days is going to be near impossible. Not that we should not fight for the best care of our patients but we may need to choose our battles. I really think the location that we as EM practitioners push for this would be in the trauma bay as the first in fluid in sick trauma patients. Having the product on site in the Trauma bay is going to be a much more realistic fight with blood bank than in our HEMS agencies.