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Recent guidelines and trials support transfusion of plasma, in addition to red blood cells and platelets, in unstable patients with traumatic injuries (J Trauma Acute Care Surg 2017; 82:605; NEJM JW Emerg Med Mar 2015 and JAMA 2015; 313:471). However, while this is standard practice in-hospital, evidence is limited regarding the efficacy of this practice in the prehospital setting. Although a recent randomized trial showed no benefit of prehospital plasma administration for patients treated in an urban setting with short ground transport times (NEJM JW Emerg Med Jul 25 2018; [e-pub] and Lancet 2018 Jul 19; [e-pub]), data are lacking for patients with longer transport times.
The Prehospital Air Medical Plasma (PAMPer) trial studied hypotensiv…