Historical collection · First published Mar 17, 2026; added to EM Weekly Oct 27, 2026. This retrospective summary may be superseded by later evidence or guidance.
← All articlesPrehospital Whole Blood in Traumatic Hemorrhage — A Randomized Controlled Trial
Summary
Across ten English air ambulance services, prehospital whole blood did not reduce death or massive transfusion within 24 hours compared with red cells and plasma. Of 942 randomized patients, 616 were analyzed after exclusions including nontraumatic hemorrhage and traumatic cardiac arrest.
Why it matters
This trial does not support claiming superior clinical outcomes from two units of prehospital whole blood over component therapy. Product choice still needs to account for local logistics and transfusion capability.
Study at a glance
- Design
- Randomized trial
- Population
- Patients with major traumatic hemorrhage treated by ten English air ambulance services.
- Sample size
- 616
- Intervention
- Up to two units of whole blood before hospital arrival.
- Comparator
- Up to two units each of red cells and plasma.
- Primary endpoint
- Death or massive transfusion of at least ten units within 24 hours.
Main findings
- Primary event: 48.7% versus 47.7%; RR 1.02 (95% CI 0.80-1.31).
- Thrombotic events appeared similar; serious adverse events numbered 31 versus 37.
Limitations
Open-label superiority trial with substantial postrandomization exclusions. It tested a limited prehospital dose and does not establish equivalence or address all hospital whole-blood protocols.
Read the primary source
Full text: Abstract available; full text paywalled.
Original sourcePMID: 41841706
Material reviewed: abstract.
Source retrieved Oct 27, 2026. Abstract reviewed; full text unavailable. Publisher indexed abstract reviewed, with primary PubMed identifier/date cross-check. Direct full-text retrieval failed; no third-party publisher PDF was used.
Corrections & review history
No corrections recorded. Human review: not yet human-reviewed.