Balian F1, Lanesman L
1CareFlight NSW, 2Westmead Hospital Trauma Service
Biography:
Fay is a Emergency Physician and Retrieval Specialist. She varied retrieval experience across Australia and currently works in NSW on the CareFlight Rapid Response Helicopter, a metropolitan rotary pre-hospital trauma service. Her other roles are in a tertiary trauma Emergency Department, and as Deputy Medical Director of NSW Ambulance. Fay’s research interests are in haemorrhagic shock and traumatic cardiac arrest. She is also interested in pre-hospital systems, and how to better integrate the patient trauma journey from the prehospital setting into the hospital.
Abstract
Aim: Prehospital blood transfusion (PHBT) is a key component of the treatment provided by physician led pre-hospital teams in Australia. Identifying patient populations that are likely to receive a PHBT would assist with resource and mission planning. The Shock Index (SI) has been studied to guide PHBT. The purpose of this study is to describe the initial SI of a cohort of trauma patients who receive a PHBT during their pre-hospital treatment.
Methods: This is a descriptive study of the initial SI of a trauma population who received a PHBT by a civilian physician-led pre-hospital trauma service in Sydney, Australia, between January 2021 to December 2025. Cases were identified and data sourced from routinely collected data sets within the retrieval service.
Results: Over the 5 years 149 adult trauma patients received a PHBT. Five were excluded from analysis due to missing data. 24 (16%) patients were in traumatic cardiac arrest and seventeen (12%) patients had an unrecordable systolic blood pressure at the time of service contact. Of the remaining 103 (72%) patients, the median SI was 1.03 (range 0.25-3.45), with the mean SI 1.13.
Conclusion: The initial SI varies for patients who ultimately require a PHBT. Further research and analysis of the initial SI by prehospital services and patient transfusion requirements would provide further information on how to best use SI in identifying at risk trauma patients.