Traumatic injuries affect people of all ages, races, and socioeconomic backgrounds. The Global Burden of Disease study showed that globally in 2019, there were more than 4.4 million deaths due to injury. Furthermore, unintentional injuries are the leading cause of death for people aged 5-29 years worldwide. Uncontrolled bleeding accounts for a significant proportion of these deaths, with approximately 20% occurring in the first 24 hours and 40% occurring within the first 30 days. Blood transfusion is a life-saving treatment in the management of bleeding patients until bleeding is controlled in hospital, typically delivered through different blood components (red blood cells, plasma and platelets). These components are derived from a whole blood donation and are stored in separate bags (units). There are challenges in carrying separate blood products, such as additional weight in kit bags, and transfusing multiple blood products at the scene can delay transport to hospital. In Ontario, Ornge Air Ambulance carries red blood cells and plasma to transfuse prehospital. However, a prehospital transfusion strategy has not been established and practice varies across the Canadian setting, and more broadly across the world. This trial aims to investigate if carrying and transfusing two units of whole blood instead of four units (two red blood cells and two plasma) is feasible and leads to better outcomes for patients.
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Proportion of patients enrolled in the study that receive a prehospital transfusion and had full study data collected
Timeframe: through study completion, up to 90 days
Number of patients that completed transfusion of at least 1 unit of assigned blood products prior to arrival to receiving lead trauma hospital
Timeframe: Enrolment to day 1 after enrolment
Number of patients that completed transfusion of all assigned blood products at the receiving lead trauma hospital
Timeframe: Enrolment to day 1 after enrolment
Number of patients screened for the study by not randomized due to lack of group O negative WB availability.
Timeframe: through study completion, an average of 1 year
To describe the distribution, redistribution and wastage of WB units produced for the study
Timeframe: through study completion, an average of 1 year