Pre-hospital activation of emergency transfusion in trauma

Background Haemostatic resuscitation is an important component of the Novel Hybrid Resuscitation strategy. This approach aims to maintain tissue oxygenation, and to counter traumatic coagulopathy maintaining the circulating with blood products which in combination resemble whole blood. Major Trauma Centres (MTCs) have adopted protocolised rapid access to appropriate blood products, triggered by recognition of ongoing significant bleeding. In some regions this protocol can be requested by pre-hospital services, some of which have the capacity to begin transfusion in the field. In our Helicopter Emergency Medical Service (HEMS) region, we access five MTCs. All allow HEMS teams to activate their protocol from scene. Each has a different protocol and pack specification.