Cameron Horner: Whole Blood in Prehospital Care – What Does the Best Evidence Tell Us?
Cameron Horner, Clinical Advisor and Clinical Audit Manager at HEMS Clinical NZ, shared a post on LinkedIn:
“Whole blood in the prehospital environment: promising concept, but what does the best trial tell us?
The SWiFT trial included 942 patients with life-threatening traumatic haemorrhage, comparing up to two units of prehospital whole blood with standard component therapy.
The headline result: no improvement in mortality or massive transfusion. The primary outcome occurred in 48.7% of the whole-blood group and 47.7% of the standard-care group.
That doesn’t mean whole blood has no place in prehospital critical care. It means a compelling physiological rationale hasn’t automatically translated into better outcomes in this trial.
There are important caveats: only 616 patients were included in the primary analysis, the dose was limited to two units, and pragmatic prehospital care involves variation in patient selection, logistics and delivery.
For CCPs, the takeaway isn’t to abandon innovation. It’s to stay honest about uncertainty, understand the system around the intervention, and keep asking whether it changes outcomes for the patients we serve — from rural communities to urban trauma scenes.
The best care is not always the newest intervention. It’s the right intervention, for the right patient, at the right time.”
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