Feasibility of prehospital freeze-dried plasma administration in a UK Helicopter Emergency Medical Service

Eur J Emerg Med. 2019 Oct;26(5):373-378. doi: 10.1097/MEJ.0000000000000585.


Background: Early transfusion of patients with major traumatic haemorrhage may improve survival. This study aims to establish the feasibility of freeze-dried plasma transfusion in a Helicopter Emergency Medical Service in the UK.

Patients and methods: A retrospective observational study of major trauma patients attended by Kent, Surrey and Sussex Helicopter Emergency Medical Service and transfused freeze-dried plasma since it was introduced in April 2014.

Results: Of the 1873 patients attended over a 12-month period before its introduction, 79 patients received packed red blood cells (4.2%) with a total of 193 units transfused. Of 1881 patients after the introduction of freeze-dried plasma, 10 patients received packed red blood cells only and 66 received both packed red blood cells and freeze-dried plasma, with a total of 158 units of packed red blood cells transfused, representing an 18% reduction between the two 12-month periods. In the 20 months since its introduction, of 216 patients transfused with at least one unit of freeze-dried plasma, 116 (54.0%) patients received both freeze-dried plasma and packed red blood cells in a 1: 1 ratio. Earlier transfusion was feasible, transferring the patient to the hospital before transfusion would have incurred a delay of 71 min (interquartile range: 59-90 min).

Conclusion: Prehospital freeze-dried plasma and packed red blood cell transfusion is feasible in a 1: 1 ratio in patients with suspected traumatic haemorrhage. The use of freeze-dried plasma as a first-line fluid bolus reduced the number of prehospital packed red blood cell units required and reduced the time to transfusion.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Air Ambulances / statistics & numerical data*
  • Blood Transfusion / methods
  • Emergency Medical Services / methods*
  • Erythrocyte Transfusion / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Plasma*
  • Resuscitation / methods
  • Retrospective Studies
  • Risk Assessment
  • Shock, Hemorrhagic / mortality
  • Shock, Hemorrhagic / therapy*
  • Survival Analysis
  • Treatment Outcome
  • United Kingdom