Richardson B1
1Lifeflight Medicine
Biography:
Retrieval Doctor and Medical Co-ordinator
FACEM
Bradley Richardson, Tara Pidgeon, Susanna Cramb, Ben Powell, Ben Aston
Bradley.richardson@lifeflight.org.au
Abstract
Aims
To characterise packed red blood cell (PRBC) utilisation within a statewide aeromedical retrieval network and examine its relevance to integrated prehospital and in-hospital haemorrhage care in a geographically dispersed setting.
Methods
A retrospective cohort study of all LifeFlight Medical Services missions in 2024 involving PRBC administration was undertaken. Missions were included where transfusion was delivered by, or under the direction of, a retrieval doctor. Primary missions and interfacility transfers (IFTs) were analysed against the overall mission cohort. Data collected included patient demographics, mission profile, transfusion indications, blood utilisation, wastage, and compliance with adjunctive therapies.
Results
Among 7,791 missions, PRBCs were administered in 226 (2.9%), more frequently in primary missions (7.6%) than IFTs (1.9%). Trauma accounted for 59% of cases; however, 41% were medical or surgical, predominantly gastrointestinal haemorrhage. Highest utilisation occurred in helicopter and road responses, reflecting early front-line resuscitation in remote environments. Adjunct compliance (tranexamic acid, calcium, and blood warming) was high, and wastage remained low (3.0%). No significant demographic differences were identified between transfused and non-transfused cohorts.
Conclusions
PRBC transfusion in aeromedical retrieval is infrequent but mission-critical, delivered in remote, resource-limited environments where early decisions influence downstream outcomes. These findings highlight the dual burden of traumatic and medical haemorrhage and reinforce the need for seamless integration between retrieval and hospital systems. Aligning protocols, logistics, and communication across the continuum enables delivery of consistent, high-quality critical care from scene to definitive management.