Timing and Delivery in the Administration of Blood and Blood Products
Hemorrhage is the leading cause of battlefield death; however, the implementation of Massive Transfusion and Thawed Plasma programs has the ability to greatly increase survival rates. Combined these two programs are a medical force and have a significant impact on survival. Furthermore, current evidence shows that the administration of a specific amount of plasma during a certain point in the transfusion process adds to this capability.
When receiving treatment, timing is imperative. This was a one the key takeaways from an on-going study known as The Prospective, Observational, Multi-Center Massive Transfusion Study (or PROMMTT). Presenter John Holcomb gave an initial report on PROMMTT to ATACCC Conference attendees Aug. 16. In his presentation, Holcomb noted that, most groups haven't spent enough time investigating the process of transfusions which makes it impossible to know what the critical moments are. The PROMMTT study which is collecting and analyzing data from ten centers around the U.S. will help to answer those and other questions.
A follow-up presentation on Tuesday morning by Bryan Cotton, reiterated that the presence of a TP program dramatically expedites transfusion of plasma to severely injured patients. It is also capable of decreasing blood utilization, meaning that blood storage and preparation can also be reduced. This is a positive development as delivery and availability are crucial in blood and blood product management; access to fresh usable blood is an on-going challenge in the combat environment. Additionally, the timing of delivery is important and can greatly impact survival rates. Efforts such as the PROMMTT study as well as the other work being conducted in this area are changing the landscape of blood and blood products as well as treatment for one of the most common causes of death on the battlefield.