Operationalizing the Deployment of Low-Titer O-Positive Whole Blood Within a Regional Trauma System.
Introduction: The implementation of a low-titer O+ whole blood (LTOWB) resuscitation algorithm, particularly in the prehospital environment, has several inherent challenges, including cost, limited and inconsistent supply, and the logistics of cold-chain management. The Southwest Texas Regional Advi...
| Published in: | Military Medicine Vol. 186; pp. 391 - 400 |
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| Main Authors: | , , , , , , , , |
| Format: | pictorial research tables/charts Journal Article |
| Published: |
Oxford University Press / USA
2021 Supplement
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148570095&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148570095 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00264075 4DV jtl: Military Medicine issn: 00264075 maglogo: N pubinfo: dt: 2021 Supplement vid: 186 pid: 622 pub: Oxford University Press / USA artinfo: ui: 148570095 148570095 NLM33499434 148570095 10.1093/milmed/usaa283 NLM33499434 148570095 ppf: 391 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Operationalizing the Deployment of Low-Titer O-Positive Whole Blood Within a Regional Trauma System. aug: au: Schaefer, Randall Tasia Long Wampler, David Summers, Rena Epley, Eric Waltman, Elizabeth Eastridge, Brian Jenkins, Donald Long, Tasia affil: Southwest Texas Regional Advisory Council (STRAC), San Antonio, TX 78227, USA. sug: subj: Blood Transfusion Emergency Medical Services Human Trauma Centers Texas Resuscitation Comparative Studies Multicenter Studies Evaluation Research Validation Studies ab: Introduction: The implementation of a low-titer O+ whole blood (LTOWB) resuscitation algorithm, particularly in the prehospital environment, has several inherent challenges, including cost, limited and inconsistent supply, and the logistics of cold-chain management. The Southwest Texas Regional Advisory Council has implemented the nation's first multidisciplinary, multi-institutional regional LTOWB program. This research effort was to illustrate the successful deployment of LTOWB within a regional trauma system.Materials and Methods: A deliberate systems approach to the deployment of LTOWB was used. Tenets of this program included the active management of blood donor sources and blood supply levels to minimize wastage as a result of expiration, maximize product utilization, the use of prehospital transfusion triggers, and efforts to decrease program costs prehospital agencies. A novel LTOWB rotation system was established using the concept of a "rotation site" and "rotation center." Standardized transfusion criteria, a regional approved equipment list, a regional Prehospital Blood Product Transfusion Record, and a robust multilevel communication plan serves as the framework for the program. The San Antonio Whole Blood Consortium was developed to create a consensus driven forum to manage and guide the program.Results: From January 2018 to October 2019, LTOWB has been placed at 18 helicopter emergency medical services (HEMS) bases, 12 ground emergency medical service (EMS) agencies, 1 level I trauma center, and 1 level IV trauma center. A total of 450 patients have received a prehospital LTOWB transfusion. Program wide, the wastage rate of LTOWB due to expiration is between 1% and 2%. No complications related to prehospital LTOWB administration have been identified.Discussion: This work demonstrates a novel model for the development of a trauma system LTOWB program. The program's implementation augments remote damage control resuscitation strategies and requires the integration and collaboration of a multidisciplinary stakeholder team to optimize efficiency, performance, and safety of the program. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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