Hemoragisk resuscitering i prehospital miljö : En litteraturstudie på ett systematiskt sätt om blodprodukter prehospitalt

Sammanfattning: Abstract Title: Haemorrhagic resuscitation in a prehospital setting Faculty: Faculty of Social and Life Sciences, Karlstad University Course: Degree project – nursing, 15 ECTS Authors: Kristina Merdén och Tomas Ögnelod Supervisor: Anders Sidenblad Examiner teacher:  Jörgen Jansson Examiner: Inger James Pages: 38 Month of examination: January 2023 Key words: Ambulance, Prehospital care, traumatic bleeding, blood transfusion   Background: The increasing number of violence in Sweden today are taking a high toll on the healthcare system and its resources. Shootings, knife violence and beatings lead to severe bleeding and injuries that require major and immediate early hemorrage resuscitation, but the possibilities and resources are limited and there is limited research in the topic.  Aim: The aim of the study is to investigate the need for blood products in ambulance with a scope on traumatic bleeding patients. Method: Literature study. Results: All different blood products reported in the results are considered safe and effective to use in a prehospital setting but with different conditions attached. The blood product that does not need a cooling chain and special need for storage is Freeze dried plasma (FTP) and Tranexamic acid (TXA). FTP and TXA can be used by road ambulances in all temperature and weather conditions and does not require special storage, making FTP ideal as a blood product in a prehospital setting. Regardless of which blood product is intended to be used, there must be a national blood organization in which the use of prehospital blood products is included. The overall result related to indications is to combine systolic blood pressure (SBT), Shock Index (SI), Glasgow coma scale (GCS) with P-lactate to obtain a safe and rapid intervention, where P-lactate is the most important indicator to identify the need for prehospital haemorrhagic resuscitation and predict organ failure. Conclusion: Our data and results show that FTP and TXA are safe and effective to use for prehospital haemorrhagic resuscitation in all prehospital settings. The indicators best suited to identify the need for prehospital haemorrhagic resuscitation quickly and effectively are primarily P-lactate, STB, GCS, SI. The blood product alone cannot increase the survival of the patients, but only put in a unified prehospital context, can we achieve successful interventions.