University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


General Medicine


Larry Herman, DMSc, MPA, PA-C, DFAAPA


In damage control resuscitation and trauma, fresh whole blood is the fluid of choice and has been proven repeatedly to be superior to crystalloid fluids. Not only does fresh whole blood increase the odds of overall survival when utilized early in resuscitation efforts, but it also decreases recovery times. However, this is not common practice in the prehospital setting across all prehospital responders. Some prehospital providers utilize fresh whole blood, some use blood products (fresh frozen plasma/packed RBCs), and others continue to utilize crystalloids as the primary means of fluid resuscitation. This article reviews prehospital fluid resuscitation guidelines, what emergency medical service (EMS) and paramedics utilize in the prehospital setting, their protocols and effectiveness in using fresh whole blood. While acknowledging and highlighting the effectiveness of some EMS systems and their use of whole blood in the prehospital setting, hopefully other systems across the nation can adopt these standards and begin delivering whole blood to patients in need in the prehospital setting.


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