Prehospital Plasma Resuscitation for Trauma-Induced Coagulopathy

Trauma-induced coagulopathy occurs after major trauma as clotting factors are rapidly consumed, leading to a vicious cycle of increased bleeding and coagulopathy. Prior military studies suggested a survival benefit from early plasma resuscitation but are confounded by survivor bias (you have to survive long enough to get the plasma).

Researchers at an urban level 1 trauma center tested whether prehospital resuscitation with plasma improved 28-day survival compared to standard resuscitation with saline in adults with hemorrhagic shock (systolic blood pressure ≤70 mm Hg or 71–90 mm Hg with tachycardia). Ambulances were randomized to carry sealed coolers of either two units of frozen plasma, which would be rapidly (<3 minutes) defrosted by a sp…