Dr Kate St Louis1, Dr Alana Harper
1Northern Regional Helicopter Limited, Auckland, New Zealand
Background:
The NZ Blood Service at ADHB has committed to a partnership with the Northern Regional Helicopter Limited (NRHL) and provides whole blood for prehospital transfusion of appropriately selected patients. The current NRHL practice is to administer up to two units of prehospital whole blood for patients who meet the transfusion criteria. Auckland HEMS use a modified version of the Assessment of Blood Consumption score as a trigger for prehospital transfusion (1,2).
There is evidence that blood transfusion is linked to hypocalcaemia. Hypocalcaemia has been associated with increased mortality and morbidity. Other emergency medical providers worldwide administer calcium concurrently with prehospital blood transfusion. (3,5, 7). Hypocalcaemia in both trauma and transfusion has been associated with increased morbidity and mortality (4, 5).
Limited current evidence demonstrates that patients receiving prehospital blood transfusion are at high risk of developing hypocalcaemia (3).
Objectives:
Review all transfusions from November 2017 until April 2021.
Identify the incidence of hypocalcaemia on arrival to ED post prehospital transfusion
Method:
Patient records will be accessed to obtain the Ionised calcium level on arrival to ED. We will also note 24 and 30 day mortality.
*Ionised hypocalcaemia has been defined as a serum iCa <1.12mmol/L and defined as severe hypocalcaemia when serum iCa is <0.9mml/L (3).
Results: 65 patients identified. Ten did not have an iCa available and were excluded.
Conclusion:
Over half of the patients who receive a prehospital blood transfusion are hypocalcaemic on arrival to Auckland ED. Auckland HEMS should consider giving calcium concurrently with blood.
Biography:
Recently completed a fellowship with Auckland HEMS and now continuing to work there as a PHRM doctor. Very happy delivering critical care anywhere or riding her bike somewhere…